Provider Demographics
NPI:1376769752
Name:ELBAHR, WAHID (DMD,MDS)
Entity Type:Individual
Prefix:DR
First Name:WAHID
Middle Name:
Last Name:ELBAHR
Suffix:
Gender:M
Credentials:DMD,MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12121 HARBOUR REACH DR. , STE 210
Mailing Address - Street 2:
Mailing Address - City:MUKILTEA
Mailing Address - State:WA
Mailing Address - Zip Code:98275
Mailing Address - Country:US
Mailing Address - Phone:425-316-8484
Mailing Address - Fax:425-338-0695
Practice Address - Street 1:12121 HARBOUR REACH DR. , STE 210
Practice Address - Street 2:
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275
Practice Address - Country:US
Practice Address - Phone:425-316-8484
Practice Address - Fax:425-338-0695
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000097291223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics