Provider Demographics
NPI:1467525352
Name:OCHOA, SHAE (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:SHAE
Middle Name:
Last Name:OCHOA
Suffix:
Gender:F
Credentials:DDS MS
Other - Prefix:
Other - First Name:BANAFSHEH
Other - Middle Name:
Other - Last Name:OCHOA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:2015 W FERGUSON RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-2925
Mailing Address - Country:US
Mailing Address - Phone:903-572-8543
Mailing Address - Fax:
Practice Address - Street 1:2015 W FERGUSON RD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-2925
Practice Address - Country:US
Practice Address - Phone:903-572-8543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209281223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics