Provider Demographics
NPI:1184701054
Name:CHAUDHARY, SHEILA UTTAM (DDS)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:UTTAM
Last Name:CHAUDHARY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 S WASHINGTON AVE
Mailing Address - Street 2:UNIT 1602
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-3854
Mailing Address - Country:US
Mailing Address - Phone:614-354-3999
Mailing Address - Fax:
Practice Address - Street 1:11885 E 12 MILE RD
Practice Address - Street 2:STE 303B
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-3474
Practice Address - Country:US
Practice Address - Phone:586-574-9800
Practice Address - Fax:586-574-9430
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019447122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist