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General NPI Number Information
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NPI Number | 1518955566
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Entity Type | Individual
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Provider Name | IRIS LAMAE SHIELDS D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 10/03/2022
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Provider Practice Location Address
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Address Line | 615 W MACPHAIL RD SUITE # 208
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City | BEL AIR
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State | MD
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Zip | 21014-4309
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Country | US
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Telephone | 410-638-0858
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Fax | 410-638-0057
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Provider Business Mailing Address
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Address Line | 4248 OVERTON AVE
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City | NOTTINGHAM
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State | MD
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Zip | 21236-4010
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Country | US
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Telephone | 410-491-9823
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Fax | 410-638-0858
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12536
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License Number State | MD
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