Healthcare Provider Details

I. General information

NPI: 1083580799
Provider Name (Legal Business Name): MUSTAFA A ALSABAHI RDH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2025
Last Update Date: 05/17/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 N DIVISION ST
SPOKANE WA
99207-2207
US

IV. Provider business mailing address

3505 E 30TH AVE
SPOKANE WA
99223-3743
US

V. Phone/Fax

Practice location:
  • Phone: 509-242-8668
  • Fax:
Mailing address:
  • Phone: 509-329-8903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number70126875
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: