Provider Demographics
NPI:1447891080
Name:SAAD, SHAHIRA (DDS)
Entity type:Individual
Prefix:DR
First Name:SHAHIRA
Middle Name:
Last Name:SAAD
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 1:1430 7TH ST APT 302
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2649
Mailing Address - Country:US
Mailing Address - Phone:602-750-3061
Mailing Address - Fax:
Practice Address - Street 1:10545 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3916
Practice Address - Country:US
Practice Address - Phone:602-750-3061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS103555122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist