Provider Demographics
NPI:1336337401
Name:NAJMI, SHAISTA Y (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHAISTA
Middle Name:Y
Last Name:NAJMI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:SHAISTA
Other - Middle Name:Y
Other - Last Name:NAJMI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:313 S DANBURY RD
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-6283
Mailing Address - Country:US
Mailing Address - Phone:201-696-7570
Mailing Address - Fax:
Practice Address - Street 1:11362 SAN JOSE BLVD
Practice Address - Street 2:SUITE #7
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-7960
Practice Address - Country:US
Practice Address - Phone:904-998-1555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-14
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 16915122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist