Provider Demographics
NPI:1164230322
Name:ABU SHAKRA, HEBAH H (DDS)
Entity type:Individual
Prefix:DR
First Name:HEBAH
Middle Name:H
Last Name:ABU SHAKRA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11229 POTOMAC CREST DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2769
Mailing Address - Country:US
Mailing Address - Phone:202-818-0078
Mailing Address - Fax:
Practice Address - Street 1:5100 WISCONSIN AVE NW STE 240
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4126
Practice Address - Country:US
Practice Address - Phone:202-686-2318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC2000431122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist