Provider Demographics
NPI:1831343250
Name:PATWARDHAN, SHEILA VINOD (DMD)
Entity type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:VINOD
Last Name:PATWARDHAN
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 1:777 AUTUMN DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-4352
Mailing Address - Country:US
Mailing Address - Phone:626-676-0370
Mailing Address - Fax:
Practice Address - Street 1:2480 MISSION ST
Practice Address - Street 2:SUITE 333
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2468
Practice Address - Country:US
Practice Address - Phone:626-676-0370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA606941223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics