Provider Demographics
NPI:1477682383
Name:MAIARY, NASEEMA SHAFI (DDS)
Entity type:Individual
Prefix:
First Name:NASEEMA
Middle Name:SHAFI
Last Name:MAIARY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 SCOVILLE ST
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06706-5812
Mailing Address - Country:US
Mailing Address - Phone:203-709-7055
Mailing Address - Fax:203-709-7055
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1956
Practice Address - Country:US
Practice Address - Phone:860-679-2808
Practice Address - Fax:860-679-1330
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT009793122300000X
NC1505641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice