Provider Demographics
NPI:1881079564
Name:MADANI, SHEEDEH (MS, DMD)
Entity type:Individual
Prefix:DR
First Name:SHEEDEH
Middle Name:
Last Name:MADANI
Suffix:
Gender:F
Credentials:MS, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 PORTLEDGE DR
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1154
Mailing Address - Country:US
Mailing Address - Phone:610-496-0745
Mailing Address - Fax:
Practice Address - Street 1:15 N PRESIDENTIAL BLVD STE 303
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1022
Practice Address - Country:US
Practice Address - Phone:610-336-8478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0408521223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry