Provider Demographics
NPI:1013457290
Name:ALSHEHRI, MAJED KHALID M (BDS)
Entity Type:Individual
Prefix:
First Name:MAJED KHALID M
Middle Name:
Last Name:ALSHEHRI
Suffix:
Gender:M
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 COMMONWEALTH AVE
Mailing Address - Street 2:APT #818
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-2522
Mailing Address - Country:US
Mailing Address - Phone:617-371-7384
Mailing Address - Fax:
Practice Address - Street 1:100 EAST NEWTON STREET BOSTON
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-638-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL130951223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics