Provider Demographics
NPI:1841858230
Name:SHEHADA, KAMEL (DMD)
Entity type:Individual
Prefix:DR
First Name:KAMEL
Middle Name:
Last Name:SHEHADA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DUNN RD UNIT G
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-3527
Mailing Address - Country:US
Mailing Address - Phone:708-717-1781
Mailing Address - Fax:
Practice Address - Street 1:125 WASHINGTON AVE FL 3
Practice Address - Street 2:
Practice Address - City:CARTERET
Practice Address - State:NJ
Practice Address - Zip Code:07008-2635
Practice Address - Country:US
Practice Address - Phone:732-733-6690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-31
Last Update Date:2023-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02899900122300000X
IL019.032117122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist