Provider Demographics
NPI:1184615593
Name:SHAIKH, KHALID N (DDS)
Entity type:Individual
Prefix:DR
First Name:KHALID
Middle Name:N
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 1:6202 CHARLOTTE AVE
Mailing Address - Street 2:STE 74
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-3036
Mailing Address - Country:US
Mailing Address - Phone:615-352-5582
Mailing Address - Fax:615-352-5055
Practice Address - Street 1:6202 CHARLOTTE AVE
Practice Address - Street 2:STE 74
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209
Practice Address - Country:US
Practice Address - Phone:615-352-5582
Practice Address - Fax:615-352-5055
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS41009122300000X
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3225102Medicaid