Provider Demographics
NPI:1831310960
Name:DHANANI, SHIREEN (DMD)
Entity Type:Individual
Prefix:
First Name:SHIREEN
Middle Name:
Last Name:DHANANI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 E DIXIE AVE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-7647
Mailing Address - Country:US
Mailing Address - Phone:352-728-8300
Mailing Address - Fax:352-728-8400
Practice Address - Street 1:918 E DIXIE AVE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-7647
Practice Address - Country:US
Practice Address - Phone:352-728-8300
Practice Address - Fax:352-728-8400
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN148421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice