Provider Demographics
NPI:1255783627
Name:RASHID, SHAISTA (DDS, MS, MPH)
Entity type:Individual
Prefix:DR
First Name:SHAISTA
Middle Name:
Last Name:RASHID
Suffix:
Gender:F
Credentials:DDS, MS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-3024
Mailing Address - Country:US
Mailing Address - Phone:515-720-8196
Mailing Address - Fax:
Practice Address - Street 1:1500 PARK AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-3024
Practice Address - Country:US
Practice Address - Phone:515-720-8196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-08
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKF009122300000X
MEFDN131223G0001X
MO2021011959122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK536737OtherUNIVERSITY OF OKLAHOM
ME010211810OtherUNE OHC
MO010211810OtherDENTISTRY