Provider Demographics
NPI:1144712704
Name:MADANI, NAHEED S (DDS)
Entity type:Individual
Prefix:
First Name:NAHEED
Middle Name:S
Last Name:MADANI
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:N72W13524 LUND LN UNIT 314
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-6122
Mailing Address - Country:US
Mailing Address - Phone:630-776-9241
Mailing Address - Fax:
Practice Address - Street 1:W183N9609 APPLETON AVE
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:WI
Practice Address - Zip Code:53022-4501
Practice Address - Country:US
Practice Address - Phone:262-677-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1001828-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist