Provider Demographics
NPI:1285737825
Name:SHAHEEDY, HALEH (DMD)
Entity type:Individual
Prefix:
First Name:HALEH
Middle Name:
Last Name:SHAHEEDY
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 1:19963 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2631
Mailing Address - Country:US
Mailing Address - Phone:818-703-0234
Mailing Address - Fax:818-703-0029
Practice Address - Street 1:19963 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2631
Practice Address - Country:US
Practice Address - Phone:818-703-0234
Practice Address - Fax:818-703-0029
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA424161223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry