Provider Demographics
NPI:1285205229
Name:SHAIKH, MISHA (DDS)
Entity Type:Individual
Prefix:
First Name:MISHA
Middle Name:
Last Name:SHAIKH
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 1:3555 NORTHBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48198-8700
Mailing Address - Country:US
Mailing Address - Phone:734-341-7980
Mailing Address - Fax:
Practice Address - Street 1:3555 NORTHBROOK DR
Practice Address - Street 2:
Practice Address - City:SUPERIOR TWP
Practice Address - State:MI
Practice Address - Zip Code:48198-8700
Practice Address - Country:US
Practice Address - Phone:734-341-7980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.033293122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist