Provider Demographics
NPI:1760939300
Name:SABBAGHAN, HASTI (DMD)
Entity Type:Individual
Prefix:
First Name:HASTI
Middle Name:
Last Name:SABBAGHAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 COMMONWEALTH AVE
Mailing Address - Street 2:UNIT 1010
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:857-540-9533
Mailing Address - Fax:
Practice Address - Street 1:47 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02188-1601
Practice Address - Country:US
Practice Address - Phone:781-337-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL 12987122300000X
MADN1857745122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist