Provider Demographics
NPI:1407924103
Name:SHAJA, NAJWA YOUNIS (DDS)
Entity Type:Individual
Prefix:
First Name:NAJWA
Middle Name:YOUNIS
Last Name:SHAJA
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 1:26021 COOLIDGE HWY
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-1109
Mailing Address - Country:US
Mailing Address - Phone:248-547-1780
Mailing Address - Fax:
Practice Address - Street 1:26021 COOLIDGE HWY
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-1109
Practice Address - Country:US
Practice Address - Phone:248-547-1780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI17385122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4170617Medicaid