Provider Demographics
NPI:1114145026
Name:SHAHABI, SHEILA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:
Last Name:SHAHABI
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 1:345 CALIFORNIA ST STE 170
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-2606
Mailing Address - Country:US
Mailing Address - Phone:415-576-9400
Mailing Address - Fax:415-291-9102
Practice Address - Street 1:345 CALIFORNIA ST STE 170
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-2606
Practice Address - Country:US
Practice Address - Phone:415-576-9400
Practice Address - Fax:415-291-9102
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA466801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice