Dr. Fawaz Omar Shihadeh
Pediatric Dentist
111 E 210th St
Bronx
, New York 10467-2401
Dr. Fawaz Omar Shihadeh
Pediatric Dentist
111 E 210th St
Bronx
, New York 10467-2401
(718) 920-4321
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About
Features
Specialties
- Pediatric Dentist
Languages spoken
- English
Location
First Address
- Dr. Fawaz Omar Shihadeh
- 111 E 210th St
- Bronx, NY
- Zip : 10467-2401
- Phone : (718) 920-4321
Second Address
- Dr. Fawaz Omar Shihadeh
- 111 E 210th St
- Bronx, NY
- Zip : 10467-2401
- Phone : (718) 920-4321
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0221X | Pediatric Dentist | 061580-01 | NY |
National Provider Identifier
| NPI | 1053815282 |
|---|---|
| Provider Name | Dr. Fawaz Omar Shihadeh |
| First Address | Bronx, NY 10467-2401 |
| Second Address | Bronx, NY 10467-2401 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/03/2018 |
| Last Update Date | 14/09/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.