Healthcare Provider Details

I. General information

NPI: 1992455307
Provider Name (Legal Business Name): SHADHA HUSSEIN HASAN AL-ZZBAIRI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2204 GENERAL BOOTH BLVD STE 400
VIRGINIA BEACH VA
23454-5934
US

IV. Provider business mailing address

1209 SAPIENT TER
CHESAPEAKE VA
23322-4424
US

V. Phone/Fax

Practice location:
  • Phone: 909-682-4942
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401418612
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: