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General NPI Number Information
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NPI Number | 1649688920
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Entity Type | Individual
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Provider Name | SHABNAAZ KAMAL DDS
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Gender | Female
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Dates
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Enumeration Date | 07/30/2014
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Last Update Date | 12/04/2019
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Provider Practice Location Address
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Address Line | 47 CLOCK TOWER PLZ
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City | ELGIN
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State | IL
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Zip | 60120-7800
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Country | US
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Telephone | 847-695-8780
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Fax |
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Provider Business Mailing Address
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Address Line | 8939 DEER MEADOW DR
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City | HOUSTON
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State | TX
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Zip | 77071-2458
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Country | US
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Telephone | 646-226-3511
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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 | 019029971
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 35821
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License Number State | TX
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