Provider Demographics
NPI:1679623136
Name:SHEIK, MON FONG (DMD)
Entity Type:Individual
Prefix:DR
First Name:MON
Middle Name:FONG
Last Name:SHEIK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15324 SPENCERVILLE CT
Mailing Address - Street 2:#101
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-1669
Mailing Address - Country:US
Mailing Address - Phone:301-476-8330
Mailing Address - Fax:301-476-8336
Practice Address - Street 1:15324 SPENCERVILLE CT
Practice Address - Street 2:#101
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-1669
Practice Address - Country:US
Practice Address - Phone:301-476-8330
Practice Address - Fax:301-476-8336
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD121541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice