Provider Demographics
NPI:1639793631
Name:SHAHBAZI, LEILA (DMD, MPH)
Entity Type:Individual
Prefix:DR
First Name:LEILA
Middle Name:
Last Name:SHAHBAZI
Suffix:
Gender:F
Credentials:DMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7231 E PRINCESS BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-9670
Mailing Address - Country:US
Mailing Address - Phone:480-585-1612
Mailing Address - Fax:
Practice Address - Street 1:7231 E PRINCESS BLVD STE 207
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-9670
Practice Address - Country:US
Practice Address - Phone:480-585-1612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-04
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0106711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice