Provider Demographics
NPI:1497124275
Name:SHEHADEH, KARIMEH HANI (DDS)
Entity Type:Individual
Prefix:DR
First Name:KARIMEH
Middle Name:HANI
Last Name:SHEHADEH
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 1:408 KNICKERBOCKER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-4102
Mailing Address - Country:US
Mailing Address - Phone:650-451-8834
Mailing Address - Fax:
Practice Address - Street 1:408 KNICKERBOCKER AVE FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-4102
Practice Address - Country:US
Practice Address - Phone:650-451-8834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058177-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice