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General NPI Number Information
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NPI Number | 1861755837
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Entity Type | Individual
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Provider Name | EDWARD ASSAD SHAMIEH DDS
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Gender | Male
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Dates
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Enumeration Date | 06/24/2012
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Last Update Date | 08/10/2025
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Provider Practice Location Address
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Address Line | 4980 ROE BLVD
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City | ROELAND PARK
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State | KS
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Zip | 66205-1110
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Country | US
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Telephone | 913-355-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 5866 FONTANA DR
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City | FAIRWAY
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State | KS
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Zip | 66205-3133
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Country | US
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Telephone | 646-724-1266
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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 | 2012019903
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 61519
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2012019903
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 61519
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License Number State | KS
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