Provider Demographics
NPI:1437345345
Name:ZAID, SHEEBA NAWAB (DDS)
Entity Type:Individual
Prefix:MRS
First Name:SHEEBA
Middle Name:NAWAB
Last Name:ZAID
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MISS
Other - First Name:SHEEBA
Other - Middle Name:
Other - Last Name:NAWAB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1226 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-1715
Mailing Address - Country:US
Mailing Address - Phone:203-269-1014
Mailing Address - Fax:203-269-2427
Practice Address - Street 1:1226 S BROAD ST
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-1715
Practice Address - Country:US
Practice Address - Phone:203-269-1014
Practice Address - Fax:203-269-2427
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051235-11223X0400X
CT99991223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008065745Medicaid