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MOHAMMED SHAFAYETUL ISLAM DDS INC
NPI 1194393595
Clinic/Center - Dental in Fresno, CA

Active since June 14, 2021
6167 N FRESNO ST STE 103, FRESNO, CA 93710(703) 945-5673(559) 981-5375 Get Directions Write a Review

NPPES record last updated: August 8, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 8, 2021, Jun 14, 2021 (2 updates tracked since 2021).

Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Authorized Official
  4. Frequently Asked Questions
  • Organization
  • Clinic/Center
  • Dental

About MOHAMMED SHAFAYETUL ISLAM DDS INC

This page provides the complete NPI Profile along with additional information for Mohammed Shafayetul Islam Dds Inc, a provider established in Fresno, California operating as a Clinic/center, focusing in dental . The healthcare provider is registered in the NPI registry with number 1194393595 assigned on June 2021. The practitioner's primary taxonomy code is 261QD0000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Mohammed Shafayetul Islam Dds (President)

NPI
1194393595 Verify this NPI
Provider Name
MOHAMMED SHAFAYETUL ISLAM DDS INC
Entity Type
Organization
Location Address
6167 N FRESNO ST STE 103 FRESNO, CA 93710
Location Phone
(703) 945-5673
Location Fax
(559) 981-5375
Mailing Address
6167 N FRESNO ST STE 103 FRESNO, CA 93710
Mailing Phone
(703) 945-5673
Mailing Fax
(559) 981-5375
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-14-2021
Last Update Date
08-08-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Dental

Taxonomy Code
261QD0000X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MOHAMMED SHAFAYETUL ISLAM DDS

Authorized Official Title
PRESIDENT
Authorized Official Phone
(703) 945-5673

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Frequently Asked Questions

What is MOHAMMED SHAFAYETUL ISLAM DDS INC's NPI number?

The NPI number assigned to this healthcare provider is 1194393595, enumerated as an "organization" on June 14, 2021.

Where is the provider located?

The provider is located at 6167 N FRESNO ST STE 103 FRESNO, CA 93710 and the phone number is (703) 945-5673.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.