Provider Demographics
NPI:1235971060
Name:SHEIKHAN, AREYA REZA (DDS)
Entity type:Individual
Prefix:
First Name:AREYA
Middle Name:REZA
Last Name:SHEIKHAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 HIDDEN GLEN CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-2416
Mailing Address - Country:US
Mailing Address - Phone:201-841-1815
Mailing Address - Fax:
Practice Address - Street 1:465 MEMORIAL DR BLDG 83, FAMILY MEDICINE
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83209-2416
Practice Address - Country:US
Practice Address - Phone:208-282-6000
Practice Address - Fax:208-282-1040
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-11
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-56371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice