Provider Demographics
NPI:1558733212
Name:HABASHY, SARAH (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:HABASHY
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 1:604 N MONTEBELLO BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-3500
Mailing Address - Country:US
Mailing Address - Phone:323-721-0799
Mailing Address - Fax:
Practice Address - Street 1:604 N MONTEBELLO BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3500
Practice Address - Country:US
Practice Address - Phone:323-721-0799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65055122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist