Provider Demographics
NPI:1679683783
Name:NAHID SHAHRY DDS LLC
Entity Type:Organization
Organization Name:NAHID SHAHRY DDS LLC
Other - Org Name:CHURCHVILLE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAHID
Authorized Official - Middle Name:Z
Authorized Official - Last Name:SHAHRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-838-5776
Mailing Address - Street 1:1301 CHURCHVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014
Mailing Address - Country:US
Mailing Address - Phone:410-838-5776
Mailing Address - Fax:410-879-3701
Practice Address - Street 1:1301 CHURCHVILLE RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014
Practice Address - Country:US
Practice Address - Phone:410-838-5776
Practice Address - Fax:410-879-3701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11612122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty