Provider Demographics
NPI:1134321672
Name:SHADID, LOAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:LOAY
Middle Name:
Last Name:SHADID
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 1:281 DURHAM AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-2504
Mailing Address - Country:US
Mailing Address - Phone:908-791-0900
Mailing Address - Fax:
Practice Address - Street 1:281 DURHAM AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080
Practice Address - Country:US
Practice Address - Phone:908-791-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ21497122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist