Provider Demographics
NPI:1811412059
Name:SHAIKH, OWAIS (DDS)
Entity Type:Individual
Prefix:
First Name:OWAIS
Middle Name:
Last Name:SHAIKH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 W ONTARIO AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-5274
Mailing Address - Country:US
Mailing Address - Phone:951-898-9700
Mailing Address - Fax:
Practice Address - Street 1:131 W ONTARIO AVE STE 102
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-5274
Practice Address - Country:US
Practice Address - Phone:951-898-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1857720122300000X
CA1056591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist