Provider Demographics
NPI:1942858618
Name:RUBECCA H SHAHID DMD PLLC
Entity Type:Organization
Organization Name:RUBECCA H SHAHID DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUBECCA
Authorized Official - Middle Name:HASAN
Authorized Official - Last Name:SHAHID
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:248-631-6883
Mailing Address - Street 1:18627 45TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-7667
Mailing Address - Country:US
Mailing Address - Phone:248-631-6883
Mailing Address - Fax:
Practice Address - Street 1:7347 35TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-5987
Practice Address - Country:US
Practice Address - Phone:248-631-6883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty