Healthcare Provider Details
I. General information
NPI: 1720870793
Provider Name (Legal Business Name): SABA N/A SEFIDABI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9601 CHESTER AVE DEPT OF
CLEVELAND OH
44106-1666
US
IV. Provider business mailing address
9601 CHESTER AVE DEPT OF
CLEVELAND OH
44106-1666
US
V. Phone/Fax
- Phone: 216-368-2460
- Fax:
- Phone: 216-368-2460
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 182535 |
| License Number State | ZZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: