Provider Demographics
NPI:1689307092
Name:UMAR SHAHBAZ, DMD, LLC
Entity Type:Organization
Organization Name:UMAR SHAHBAZ, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:UMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHBAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-736-0312
Mailing Address - Street 1:9110 PHILADELPHIA RD STE 214
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4325
Mailing Address - Country:US
Mailing Address - Phone:410-780-0120
Mailing Address - Fax:
Practice Address - Street 1:9110 PHILADELPHIA RD STE 214
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-4325
Practice Address - Country:US
Practice Address - Phone:410-780-0120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-04
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental