Provider Demographics
NPI:1700045002
Name:SOBIEH, RADWA M (DDS)
Entity Type:Individual
Prefix:
First Name:RADWA
Middle Name:M
Last Name:SOBIEH
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 1:2372 BIZZONE CIR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-1522
Mailing Address - Country:US
Mailing Address - Phone:763-221-8110
Mailing Address - Fax:
Practice Address - Street 1:2372 BIZZONE CIR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-1522
Practice Address - Country:US
Practice Address - Phone:763-221-8110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2710122300000X
VA0401412792122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist