Provider Demographics
NPI:1003625385
Name:SHAZA AWAD DDS
Entity type:Organization
Organization Name:SHAZA AWAD DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAZA
Authorized Official - Middle Name:
Authorized Official - Last Name:AWAD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-582-3900
Mailing Address - Street 1:2184 N BEECH DALY RD STE 4
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-3492
Mailing Address - Country:US
Mailing Address - Phone:313-582-3900
Mailing Address - Fax:
Practice Address - Street 1:2184 N BEECH DALY RD STE 4
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-3492
Practice Address - Country:US
Practice Address - Phone:313-582-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental