Healthcare Provider Details

I. General information

NPI: 1982597183
Provider Name (Legal Business Name): SABA TOHIDKHAH DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2025
Last Update Date: 05/29/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 DELAWARE ST SE DEPARTMENT OF PERIODONTOLOGY
MINNEAPOLIS MN
55455-0357
US

IV. Provider business mailing address

515 DELAWARE ST SE DEPARTMENT OF PERIODONTOLOGY
MINNEAPOLIS MN
55455
US

V. Phone/Fax

Practice location:
  • Phone: 929-206-4334
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberR898
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: