Healthcare Provider Details

I. General information

NPI: 1609926682
Provider Name (Legal Business Name): SCHEHERAZADE JAAMAC D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 WARM SPRINGS AVE
MARTINSBURG WV
25404-3800
US

IV. Provider business mailing address

PO BOX 1146
MARTINSBURG WV
25402-1146
US

V. Phone/Fax

Practice location:
  • Phone: 304-267-0250
  • Fax:
Mailing address:
  • Phone: 304-263-4999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number9940
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4618
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN012337
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number0401414982
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: