Provider Demographics
NPI:1083905038
Name:SYED, ASMAT SHAIKH (DDS)
Entity Type:Individual
Prefix:
First Name:ASMAT
Middle Name:SHAIKH
Last Name:SYED
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 1:4332 KISSENA BLVD APT 6P
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-2984
Mailing Address - Country:US
Mailing Address - Phone:502-345-8721
Mailing Address - Fax:
Practice Address - Street 1:4332 KISSENA BLVD APT 6P
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2984
Practice Address - Country:US
Practice Address - Phone:502-345-8721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ22DI02509800122300000X
NY056531122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program