Provider Demographics
NPI:1467401620
Name:SAKR, SHAABAN ABDELGHANI (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHAABAN
Middle Name:ABDELGHANI
Last Name:SAKR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10130 WARNER AVE
Mailing Address - Street 2:SUITE #F
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-1619
Mailing Address - Country:US
Mailing Address - Phone:714-378-5950
Mailing Address - Fax:714-378-5960
Practice Address - Street 1:10130 WARNER AVE
Practice Address - Street 2:SUITE #F
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-1619
Practice Address - Country:US
Practice Address - Phone:714-378-5950
Practice Address - Fax:714-378-5960
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA415361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice