Provider Demographics
NPI:1356495246
Name:NAKHAEI, SHEIDA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHEIDA
Middle Name:
Last Name:NAKHAEI
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 1:2313 WESTPORT LN
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-1210
Mailing Address - Country:US
Mailing Address - Phone:410-721-6638
Mailing Address - Fax:
Practice Address - Street 1:6411 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-1822
Practice Address - Country:US
Practice Address - Phone:410-254-8624
Practice Address - Fax:410-254-8670
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD134551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice