Provider Demographics
NPI:1972909166
Name:SHAFIE, MARZIEH (DMD)
Entity Type:Individual
Prefix:
First Name:MARZIEH
Middle Name:
Last Name:SHAFIE
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 1:885 ROCKY RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-7549
Mailing Address - Country:US
Mailing Address - Phone:954-594-6934
Mailing Address - Fax:
Practice Address - Street 1:421 W 104TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234-4138
Practice Address - Country:US
Practice Address - Phone:303-872-5970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-14
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN00202573122300000X
NMDD4170122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist