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General NPI Number Information
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NPI Number | 1003687567
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Entity Type | Individual
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Provider Name | SYED SHAFAY YAQEEN DDS
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Gender | Male
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Dates
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Enumeration Date | 01/12/2024
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 2200 NORTH NURSULA STREET BUILDNG 5 APT 444
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City | AURORA
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State | CO
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Zip | 80045
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Country | US
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Telephone | 682-313-5321
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 NORTH URSULA STREET BUILDING # 5 444
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City | AURORA
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State | CO
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Zip | 80045
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Country | US
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Telephone | 682-313-5321
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN.00205850
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License Number State | CO
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