Provider Demographics
NPI:1720165871
Name:SENGEL, AMANDA MAREE (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MAREE
Last Name:SENGEL
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 1:116 CANDLER OAKS LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-3714
Mailing Address - Country:US
Mailing Address - Phone:405-833-8491
Mailing Address - Fax:
Practice Address - Street 1:116 CANDLER OAKS LN
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3714
Practice Address - Country:US
Practice Address - Phone:405-833-8491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0133991223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA9184505OtherDORAL
GA320454787AMedicaid