Provider Demographics
NPI:1003031766
Name:SHNAYDMAN, MARIYA (DMD)
Entity Type:Individual
Prefix:
First Name:MARIYA
Middle Name:
Last Name:SHNAYDMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HUNNEWELL TER
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-1444
Mailing Address - Country:US
Mailing Address - Phone:617-721-8917
Mailing Address - Fax:
Practice Address - Street 1:1249 ASHLEY BLVD
Practice Address - Street 2:SUITE #1
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-1536
Practice Address - Country:US
Practice Address - Phone:508-998-1178
Practice Address - Fax:508-995-1775
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA205121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice