Provider Demographics
NPI:1457837072
Name:JAFFERY, SYEDA MAHEEN (DMD)
Entity Type:Individual
Prefix:
First Name:SYEDA
Middle Name:MAHEEN
Last Name:JAFFERY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 MANTUA PIKE STE 1
Mailing Address - Street 2:
Mailing Address - City:WOODBURY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08097-1225
Mailing Address - Country:US
Mailing Address - Phone:856-345-9900
Mailing Address - Fax:
Practice Address - Street 1:1006 MANTUA PIKE STE 1
Practice Address - Street 2:
Practice Address - City:WOODBURY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08097-1225
Practice Address - Country:US
Practice Address - Phone:345-990-0856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI027227001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice