Provider Demographics
NPI:1285516559
Name:ZOMA, SHAHAD (DMD)
Entity type:Individual
Prefix:DR
First Name:SHAHAD
Middle Name:
Last Name:ZOMA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:479 OAK ST
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-4429
Mailing Address - Country:US
Mailing Address - Phone:248-943-9351
Mailing Address - Fax:
Practice Address - Street 1:4833 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1357
Practice Address - Country:US
Practice Address - Phone:847-673-7118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.036320122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist