Provider Demographics
NPI:1942773353
Name:SEIDMAN, SHELDON (DDS)
Entity Type:Individual
Prefix:
First Name:SHELDON
Middle Name:
Last Name:SEIDMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 VENTURA LN
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2302
Mailing Address - Country:US
Mailing Address - Phone:954-341-7331
Mailing Address - Fax:
Practice Address - Street 1:7601 VENTURA LN
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33067-2302
Practice Address - Country:US
Practice Address - Phone:954-341-7331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN7156122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist