Provider Demographics
NPI:1760290605
Name:SHAHID, MUHAMMAD RAZA (DDS)
Entity type:Individual
Prefix:
First Name:MUHAMMAD RAZA
Middle Name:
Last Name:SHAHID
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5761 S US HIGHWAY 17/92 STE 10011005
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-3819
Mailing Address - Country:US
Mailing Address - Phone:407-670-0557
Mailing Address - Fax:
Practice Address - Street 1:5761 S US HIGHWAY 17/92
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-3819
Practice Address - Country:US
Practice Address - Phone:407-670-0557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-24
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN298541223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Yes1223G0001XDental ProvidersDentistGeneral Practice