Provider Demographics
NPI:1275371148
Name:NASHAAT, MAY MOHAMMED (DMD)
Entity type:Individual
Prefix:
First Name:MAY
Middle Name:MOHAMMED
Last Name:NASHAAT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13132 WINONA WAY
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-8542
Mailing Address - Country:US
Mailing Address - Phone:760-885-4626
Mailing Address - Fax:
Practice Address - Street 1:13132 WINONA WAY
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-8542
Practice Address - Country:US
Practice Address - Phone:760-885-4626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA110636122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program