Provider Demographics
NPI:1083703128
Name:SABA, SHADI (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHADI
Middle Name:
Last Name:SABA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21155 WHITFIELD PLACE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165
Mailing Address - Country:US
Mailing Address - Phone:703-404-7222
Mailing Address - Fax:703-444-5200
Practice Address - Street 1:21155 WHITFIELD PLACE
Practice Address - Street 2:SUITE 107
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165
Practice Address - Country:US
Practice Address - Phone:703-404-7222
Practice Address - Fax:703-444-5200
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010082381223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics