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General NPI Number Information
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NPI Number | 1073447017
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Entity Type | Individual
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Provider Name | SHAYAN SHAHID DDS
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Gender | Male
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Dates
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Enumeration Date | 06/12/2026
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Last Update Date | 06/12/2026
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Provider Practice Location Address
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Address Line | 600 CHESTNUT STREET EXT STE BRADFORD
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City | BRADFORD
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State | PA
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Zip | 16701-5438
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Country | US
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Telephone | 814-366-5955
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Fax |
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Provider Business Mailing Address
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Address Line | 113 LEICESTER ST
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City | PORT CHESTER
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State | NY
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Zip | 10573-2617
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Country | US
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Telephone | 914-223-4224
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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 | DS045773
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License Number State | PA
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