Provider Demographics
NPI:1275898157
Name:ABTAHI, SAHAR (DMD)
Entity Type:Individual
Prefix:DR
First Name:SAHAR
Middle Name:
Last Name:ABTAHI
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 1:2390 PEACE PORTAL DR STE 8348
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:WA
Mailing Address - Zip Code:98230-8062
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7313 120 ST SUITE 203
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:BRITISH COLUMBIA
Practice Address - Zip Code:V4C 6P5
Practice Address - Country:CA
Practice Address - Phone:604-590-1172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL 11598122300000X
WADE609362631223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist