Healthcare Provider Details

I. General information

NPI: 1487910782
Provider Name (Legal Business Name): SAIMA IJAZ SYED DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 12/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S RIVER ST
HACKENSACK NJ
07601-6651
US

IV. Provider business mailing address

203 SOUTH HAMPTON TERRACE 203
EDGEWATER NJ
07020
US

V. Phone/Fax

Practice location:
  • Phone: 201-641-5240
  • Fax:
Mailing address:
  • Phone: 212-213-4050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number056950
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22D102490500
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: