Provider Demographics
NPI:1326642836
Name:SHEIKH M EUSUF DDS PC
Entity Type:Organization
Organization Name:SHEIKH M EUSUF DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEIKH
Authorized Official - Middle Name:M
Authorized Official - Last Name:EUSUF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:646-369-4601
Mailing Address - Street 1:17824 GRAND CENTRAL PKWY
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-2211
Mailing Address - Country:US
Mailing Address - Phone:646-369-4601
Mailing Address - Fax:
Practice Address - Street 1:1219 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-3420
Practice Address - Country:US
Practice Address - Phone:718-647-6057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty