Provider Demographics
NPI:1992158133
Name:GAUR, SHEENA (DDS)
Entity type:Individual
Prefix:DR
First Name:SHEENA
Middle Name:
Last Name:GAUR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907 88TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040
Mailing Address - Country:US
Mailing Address - Phone:718-610-9308
Mailing Address - Fax:
Practice Address - Street 1:10216 SE 256TH ST
Practice Address - Street 2:STE 108
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-6437
Practice Address - Country:US
Practice Address - Phone:253-856-3384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60645089122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist