MEDICARE: SARAH GEORGE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	6557	LA

General Provider Information

NPI Number	:	1821478223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH GEORGE DDS

Provider Business Mailing Address
First Line	:	142 INDEPENDENCE BLVD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6718
Country	:	US
Telephone Number	:	757-224-3004
Fax Number	:

Provider Business Practice Location Address
First Line	:	142 INDEPENDENCE BLVD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6718
Country	:	US
Telephone Number	:	757-224-3004
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2015
Last Update Date	:	02/24/2020

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