Provider Demographics
NPI:1003687567
Name:YAQEEN, SYED SHAFAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:SYED SHAFAY
Middle Name:
Last Name:YAQEEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 NORTH URSULA STREET BUILDING # 5
Mailing Address - Street 2:444
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045
Mailing Address - Country:US
Mailing Address - Phone:682-313-5321
Mailing Address - Fax:
Practice Address - Street 1:2200 NORTH NURSULA STREET BUILDNG 5 APT 444
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045
Practice Address - Country:US
Practice Address - Phone:682-313-5321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00205850122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist