=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962615690
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEVEN S SABATINO DDS, MS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/08/2007
-----------------------------------------------------
Last Update Date | 10/29/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16620 N 40TH ST SUITE A-1
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85032-3348
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-485-4700
-----------------------------------------------------
Fax | 602-485-4720
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16620 N 40TH ST SUITE A-1
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85032-3348
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-485-4700
-----------------------------------------------------
Fax | 602-485-4720
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223X0400X
-----------------------------------------------------
Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
-----------------------------------------------------
License Number | D3721
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------