Provider Demographics
NPI:1942470455
Name:KHALEEL, SAFA AHMED (DDS)
Entity Type:Individual
Prefix:
First Name:SAFA
Middle Name:AHMED
Last Name:KHALEEL
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 1:4150 CESAR CHAVEZ ST APT 6
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-1900
Mailing Address - Country:US
Mailing Address - Phone:213-422-8511
Mailing Address - Fax:
Practice Address - Street 1:2290 BIRCH ST
Practice Address - Street 2:SUITE B
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1558
Practice Address - Country:US
Practice Address - Phone:650-318-1261
Practice Address - Fax:408-716-3208
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-11
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56421122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist