Provider Demographics
NPI:1417798729
Name:SHAMSI, MAHAD NADEEM (DMD)
Entity type:Individual
Prefix:
First Name:MAHAD
Middle Name:NADEEM
Last Name:SHAMSI
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 1:1815 MEREDITH LN
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-3657
Mailing Address - Country:US
Mailing Address - Phone:215-219-4312
Mailing Address - Fax:
Practice Address - Street 1:1 BELMONT AVE STE 516
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1608
Practice Address - Country:US
Practice Address - Phone:484-278-4134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS044655122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist