Provider Demographics
NPI:1740560127
Name:SABOOWALA, INSIYA HUSENI (DDS)
Entity Type:Individual
Prefix:DR
First Name:INSIYA
Middle Name:HUSENI
Last Name:SABOOWALA
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 1:11113 WILKINSON AVE
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-4734
Mailing Address - Country:US
Mailing Address - Phone:510-400-8023
Mailing Address - Fax:
Practice Address - Street 1:48023 PURPLELEAF ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-7505
Practice Address - Country:US
Practice Address - Phone:469-247-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA607201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice