Provider Demographics
NPI:1811145444
Name:MUNEER, SHAIJA (DDS)
Entity type:Individual
Prefix:
First Name:SHAIJA
Middle Name:
Last Name:MUNEER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SHAIJA
Other - Middle Name:
Other - Last Name:AZIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:615 WYCKOFF AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-1353
Mailing Address - Country:US
Mailing Address - Phone:201-891-0409
Mailing Address - Fax:
Practice Address - Street 1:615 WYCKOFF AVE STE 2
Practice Address - Street 2:
Practice Address - City:WYCKOFF
Practice Address - State:NJ
Practice Address - Zip Code:07481-1353
Practice Address - Country:US
Practice Address - Phone:201-891-0409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D123562001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22DI02356200OtherSTATE