Shahabuddin, Mohammed

Shahabuddin, Mohammed is an sole proprietor health care provider with primary practice located at 3004 36Th Ave , Long Island City NY 11106-2315. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Shahabuddin, Mohammed can be contacted via phone (718) 361-8677.

Contact Information

Primary practice address
3004 36Th Ave Long Island City NY 11106-2315
Fax: (718) 361-0278
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 042617 New York

Profile Details

NPI number 1245229210
LBN Legal business name Shahabuddin, Mohammed
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 20th, 2005
Last updated Apr 26th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245229210 NPPES
New York MEDICAID 01172485

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