Provider Demographics
NPI:1073714531
Name:SABAH, NESREEN H (DMD)
Entity Type:Individual
Prefix:DR
First Name:NESREEN
Middle Name:H
Last Name:SABAH
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 1:10132 BALTIMORE NATIONAL PIKE STE C
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-3607
Mailing Address - Country:US
Mailing Address - Phone:410-567-0729
Mailing Address - Fax:
Practice Address - Street 1:10132 BALTIMORE NATIONAL PIKE STE C
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-3607
Practice Address - Country:US
Practice Address - Phone:410-567-0729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9258122300000X
ORD87301223G0001X
MD15957122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice