Provider Demographics
NPI:1477543825
Name:ILYAS, SHEIKH M (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHEIKH
Middle Name:M
Last Name:ILYAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 MAIN ST STE F
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-3009
Mailing Address - Country:US
Mailing Address - Phone:203-790-0111
Mailing Address - Fax:
Practice Address - Street 1:54 MAIN ST
Practice Address - Street 2:STE F
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-3009
Practice Address - Country:US
Practice Address - Phone:203-730-8440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0094131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice