Provider Demographics
NPI:1477574317
Name:SHAHHAL, RIMA CHEHADE (DDS)
Entity Type:Individual
Prefix:DR
First Name:RIMA
Middle Name:CHEHADE
Last Name:SHAHHAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 NORDAHL RD STE 121
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-3545
Mailing Address - Country:US
Mailing Address - Phone:760-746-7008
Mailing Address - Fax:760-739-0187
Practice Address - Street 1:740 NORDAHL RD STE 121
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-3545
Practice Address - Country:US
Practice Address - Phone:760-746-7008
Practice Address - Fax:760-739-0187
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0339141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice