Provider Demographics
NPI:1801077904
Name:SHEIKH, HASEEB NISAR
Entity type:Individual
Prefix:
First Name:HASEEB
Middle Name:NISAR
Last Name:SHEIKH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 E HATCH RD
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95351-5075
Mailing Address - Country:US
Mailing Address - Phone:209-538-9552
Mailing Address - Fax:209-538-9558
Practice Address - Street 1:1720 E HATCH RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95351-5075
Practice Address - Country:US
Practice Address - Phone:209-538-9552
Practice Address - Fax:209-538-9558
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56248122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG98011-02OtherHEALTHY FAMILIES
CAG9204401OtherDENTICAL