Provider Demographics
NPI:1811077621
Name:MALIK, SHAZIA SHAHID (DDS)
Entity type:Individual
Prefix:DR
First Name:SHAZIA
Middle Name:SHAHID
Last Name:MALIK
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 1:27006 FORDHAM DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-8730
Mailing Address - Country:US
Mailing Address - Phone:813-907-5924
Mailing Address - Fax:813-633-9733
Practice Address - Street 1:27006 FORDHAM DR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-8730
Practice Address - Country:US
Practice Address - Phone:813-907-5924
Practice Address - Fax:813-633-9733
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 176761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice