Provider Demographics
NPI:1780350512
Name:WANI, SEHLA
Entity type:Individual
Prefix:DR
First Name:SEHLA
Middle Name:
Last Name:WANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 FOUNTAYNE LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2673
Mailing Address - Country:US
Mailing Address - Phone:609-647-2566
Mailing Address - Fax:
Practice Address - Street 1:116 FOUNTAYNE LN
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2673
Practice Address - Country:US
Practice Address - Phone:609-647-2566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02860500122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist