Provider Demographics
NPI:1801524152
Name:SABA, FADY (DDS)
Entity type:Individual
Prefix:
First Name:FADY
Middle Name:
Last Name:SABA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11243 SAN LUCAS DR APT C
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3200
Mailing Address - Country:US
Mailing Address - Phone:951-475-8055
Mailing Address - Fax:
Practice Address - Street 1:8715 TRAUTWEIN RD STE A
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92508-9474
Practice Address - Country:US
Practice Address - Phone:951-776-1330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107765122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist