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General NPI Number Information
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NPI Number | 1659609865
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Entity Type | Individual
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Provider Name | ANDLEEB SHABAHAT DDS
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Gender | Female
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Dates
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Enumeration Date | 11/28/2009
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Last Update Date | 01/17/2026
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Provider Practice Location Address
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Address Line | 2 S MAIN ST STE 2
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City | LODI
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State | NJ
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Zip | 07644-2228
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Country | US
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Telephone | 973-779-4088
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Fax | 973-778-2265
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Provider Business Mailing Address
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Address Line | 704 GEORGE ST
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City | TEANECK
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State | NJ
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Zip | 07666-5355
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Country | US
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Telephone | 201-881-6622
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI02429300
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License Number State | NJ
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