Provider Demographics
NPI:1104511948
Name:JETHWANI, SABINA (DMD)
Entity type:Individual
Prefix:DR
First Name:SABINA
Middle Name:
Last Name:JETHWANI
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 1:26 HARPERS CROFT
Mailing Address - Street 2:
Mailing Address - City:MARKHAM
Mailing Address - State:ON
Mailing Address - Zip Code:L3R 6L1
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12637 TENTH LINE #101
Practice Address - Street 2:
Practice Address - City:STOUFFVILLE
Practice Address - State:ONTARIO
Practice Address - Zip Code:L4A2X5
Practice Address - Country:CA
Practice Address - Phone:905-591-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN19340122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist