Provider Demographics
NPI:1538530639
Name:AL SHAIKHLY, BASIL I (DDS)
Entity type:Individual
Prefix:
First Name:BASIL
Middle Name:I
Last Name:AL SHAIKHLY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 SCRIPTURE ST STE 201
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2440
Mailing Address - Country:US
Mailing Address - Phone:940-320-0077
Mailing Address - Fax:940-320-0076
Practice Address - Street 1:2505 SCRIPTURE ST STE 201
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2440
Practice Address - Country:US
Practice Address - Phone:940-320-0077
Practice Address - Fax:940-320-0076
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX338361223E0200X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics