Provider Demographics
NPI:1447542311
Name:DEDANIA, SHEETAL JAY (MD)
Entity type:Individual
Prefix:
First Name:SHEETAL
Middle Name:JAY
Last Name:DEDANIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3418 BROWN ST NW # 2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-1898
Mailing Address - Country:US
Mailing Address - Phone:901-292-0971
Mailing Address - Fax:
Practice Address - Street 1:1133 21ST ST NW STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3324
Practice Address - Country:US
Practice Address - Phone:202-331-1740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101258409207V00000X
MDD0079843207V00000X
DCMD043587207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology