Healthcare Provider Details

I. General information

NPI: 1467292375
Provider Name (Legal Business Name): MAJID SHAIK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2024
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2409 SE DELAWARE AVE STE 100
ANKENY IA
50021-4568
US

IV. Provider business mailing address

2409 SE DELAWARE AVE STE 100
ANKENY IA
50021-4568
US

V. Phone/Fax

Practice location:
  • Phone: 630-407-4330
  • Fax:
Mailing address:
  • Phone: 630-407-4330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS10476
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: