Provider Demographics
NPI:1134251622
Name:SHAIBANI, KAMAND (DMD)
Entity type:Individual
Prefix:DR
First Name:KAMAND
Middle Name:
Last Name:SHAIBANI
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 1:9 KASSUL PARK
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-1611
Mailing Address - Country:US
Mailing Address - Phone:671-945-0146
Mailing Address - Fax:
Practice Address - Street 1:83 CAMBRIDGE ST
Practice Address - Street 2:SUITE 3A
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4181
Practice Address - Country:US
Practice Address - Phone:781-221-7171
Practice Address - Fax:781-221-0171
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19601122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist