Provider Demographics
NPI:1902635774
Name:SHAHIN, LINDA (DMD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:SHAHIN
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 1:19110 SW 197TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-1959
Mailing Address - Country:US
Mailing Address - Phone:786-374-4217
Mailing Address - Fax:
Practice Address - Street 1:551 N FEDERAL HWY STE 900
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2559
Practice Address - Country:US
Practice Address - Phone:954-358-2722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN294681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice