Provider Demographics
NPI:1467784009
Name:ZAHIR, SHABANA (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHABANA
Middle Name:
Last Name:ZAHIR
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 1:367 INDEPENDENCE BLVD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-2822
Mailing Address - Country:US
Mailing Address - Phone:757-962-7000
Mailing Address - Fax:757-962-9335
Practice Address - Street 1:367 INDEPENDENCE BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-2822
Practice Address - Country:US
Practice Address - Phone:757-962-7000
Practice Address - Fax:757-962-9335
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-08
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014121671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2508404Medicaid