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General NPI Number Information
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NPI Number | 1336337401
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Entity Type | Individual
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Provider Name | SHAISTA Y NAJMI D.M.D
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Gender | Female
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Dates
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Enumeration Date | 10/14/2007
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Last Update Date | 10/13/2009
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Provider Practice Location Address
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Address Line | 11362 SAN JOSE BLVD SUITE #7
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City | JACKSONVILLE
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State | FL
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Zip | 32223-7960
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Country | US
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Telephone | 904-998-1555
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Fax |
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Provider Business Mailing Address
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Address Line | 313 S DANBURY RD
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City | SAINT JOHNS
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State | FL
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Zip | 32259-6283
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Country | US
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Telephone | 201-696-7570
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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 | DN 16915
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License Number State | FL
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