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General NPI Number Information
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NPI Number | 1558871558
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Entity Type | Individual
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Provider Name | SHABNAM BEHDIN D.D.S
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Gender | Female
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Dates
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Enumeration Date | 10/04/2017
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Last Update Date | 11/18/2022
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Provider Practice Location Address
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Address Line | 1382 WESTBORO
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City | BIRMINGHAM
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State | MI
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Zip | 48009-5887
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Country | US
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Telephone | 248-417-9733
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Fax |
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Provider Business Mailing Address
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Address Line | 1382 WESTBORO
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City | BIRMINGHAM
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State | MI
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Zip | 48009-5887
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Country | US
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Telephone | 248-417-9733
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 2901600667
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License Number State | MI
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