Provider Demographics
NPI:1780893511
Name:SEDELL, ALAN NEAL (DMD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:NEAL
Last Name:SEDELL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7421 W SADDLEHORN RD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-7365
Mailing Address - Country:US
Mailing Address - Phone:973-879-5263
Mailing Address - Fax:
Practice Address - Street 1:20100 N 51ST AVE STE D410
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-5006
Practice Address - Country:US
Practice Address - Phone:623-292-7284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0452731223E0200X
AZD0108251223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics