Provider Demographics
NPI:1851566129
Name:AMJAD SHEIKH DDS PA
Entity Type:Organization
Organization Name:AMJAD SHEIKH DDS PA
Other - Org Name:LA. PLAZA DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMJAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHEIKH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-674-0811
Mailing Address - Street 1:7008 LYONS AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77020-5359
Mailing Address - Country:US
Mailing Address - Phone:713-674-0811
Mailing Address - Fax:713-671-9221
Practice Address - Street 1:7008 LYONS AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77020-5359
Practice Address - Country:US
Practice Address - Phone:713-674-0811
Practice Address - Fax:713-671-9221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210471223G0001X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161328301Medicaid