Provider Demographics
NPI:1205154838
Name:SULTANA, SHAHIN AFROZ (DDS)
Entity type:Individual
Prefix:
First Name:SHAHIN
Middle Name:AFROZ
Last Name:SULTANA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SHAHIN
Other - Middle Name:
Other - Last Name:SULTANA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:9203 SKILLMAN ST,
Mailing Address - Street 2:STE#126
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243
Mailing Address - Country:US
Mailing Address - Phone:214-367-6213
Mailing Address - Fax:214-367-6217
Practice Address - Street 1:9203 SKILLMAN ST
Practice Address - Street 2:STE# 126
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-9032
Practice Address - Country:US
Practice Address - Phone:214-367-6213
Practice Address - Fax:214-367-6217
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6329122300000X
TX30713122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist