Provider Demographics
NPI:1528802709
Name:SHAMS, ZOYA (DDS)
Entity type:Individual
Prefix:DR
First Name:ZOYA
Middle Name:
Last Name:SHAMS
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 1:1403 OAK BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-9534
Mailing Address - Country:US
Mailing Address - Phone:630-730-4335
Mailing Address - Fax:
Practice Address - Street 1:1261 N LAKE ST STE J
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-2471
Practice Address - Country:US
Practice Address - Phone:630-801-0002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILTBD1223D0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty