Provider Demographics
NPI:1083940126
Name:SEBBAHI, RAJIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAJIA
Middle Name:
Last Name:SEBBAHI
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 1:1394 CRUSHED APPLE DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25403-7709
Mailing Address - Country:US
Mailing Address - Phone:617-372-1157
Mailing Address - Fax:
Practice Address - Street 1:1394 CRUSHED APPLE DR
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25403-7709
Practice Address - Country:US
Practice Address - Phone:617-372-1157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-25
Last Update Date:2009-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV38081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics