Provider Demographics
NPI:1467803478
Name:SHAHID, RUBECCA HASAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:RUBECCA
Middle Name:HASAN
Last Name:SHAHID
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 1:7347 35TH AVE NE STE C
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115
Mailing Address - Country:US
Mailing Address - Phone:206-526-9040
Mailing Address - Fax:
Practice Address - Street 1:7347 35TH AVE NE STE C
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-5987
Practice Address - Country:US
Practice Address - Phone:206-526-9040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0308011223G0001X
WADE607011351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice