Provider Demographics
NPI:1508403155
Name:IDEAL SMILES FAMILY & COSMETIC DENTISTRY
Entity Type:Organization
Organization Name:IDEAL SMILES FAMILY & COSMETIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHABANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAHIR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:757-962-7000
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
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLANTIC DENTAL CARE, PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental