Provider Demographics
NPI:1053642249
Name:SHAMS, LAILA Z (DDS)
Entity Type:Individual
Prefix:
First Name:LAILA
Middle Name:Z
Last Name:SHAMS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:543 SOUTH ST APT 8
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-3522
Mailing Address - Country:US
Mailing Address - Phone:818-913-2410
Mailing Address - Fax:
Practice Address - Street 1:543 SOUTH ST APT 8
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-3522
Practice Address - Country:US
Practice Address - Phone:818-913-2410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA588201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice