Provider Demographics
NPI:1750823951
Name:SHAH, YILDIZ OMAR (DMD)
Entity Type:Individual
Prefix:MRS
First Name:YILDIZ
Middle Name:OMAR
Last Name:SHAH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 PONDS EDGE DR STE 2
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-9389
Mailing Address - Country:US
Mailing Address - Phone:610-388-4466
Mailing Address - Fax:
Practice Address - Street 1:8 PONDS EDGE DR STE 2
Practice Address - Street 2:
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317
Practice Address - Country:US
Practice Address - Phone:773-372-3435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-06
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS041112122300000X
WADE60693244122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist