MEDICARE: SARAH MARY VARGHESE DMD

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	064161	NY

General Provider Information

NPI Number	:	1871282517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MARY VARGHESE DMD

Provider Business Mailing Address
First Line	:	915 RIPLEY LN
Second Line	:
City	:	OYSTER BAY
State	:	NY
Zip	:	11771-4605
Country	:	US
Telephone Number	:	781-697-5330
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 FRANKLIN AVE STE L11
Second Line	:
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-5813
Country	:	US
Telephone Number	:	516-825-3247
Fax Number	:

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

Provider Enumeration Date	:	05/08/2023
Last Update Date	:	05/07/2026

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