Provider Demographics
NPI:1689081820
Name:SHEIKH, IQBAL
Entity Type:Individual
Prefix:
First Name:IQBAL
Middle Name:
Last Name:SHEIKH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3416 W LASKEY RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4015
Mailing Address - Country:US
Mailing Address - Phone:419-473-8885
Mailing Address - Fax:
Practice Address - Street 1:3416 W LASKEY RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4015
Practice Address - Country:US
Practice Address - Phone:419-473-8885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901021683122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist