Provider Demographics
NPI:1548710437
Name:HUDSON, SHEILA (RDH)
Entity type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:
Last Name:HUDSON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:MRS
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:SHEEHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:10700 ACADEMY RD NE
Mailing Address - Street 2:APT # 921
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-7378
Mailing Address - Country:US
Mailing Address - Phone:505-506-4060
Mailing Address - Fax:575-289-3648
Practice Address - Street 1:10700 ACADEMY RD NE
Practice Address - Street 2:APT # 921
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-7378
Practice Address - Country:US
Practice Address - Phone:505-506-4060
Practice Address - Fax:575-289-3648
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDH 1213124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist