Healthcare Provider Details

I. General information

NPI: 1710352968
Provider Name (Legal Business Name): SARA BUKHARI, DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2015
Last Update Date: 12/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4731 E UNION HILLS DR SUITES 108-110
PHOENIX AZ
85050-3310
US

IV. Provider business mailing address

7500 E DEER VALLEY RD UNIT 164
SCOTTSDALE AZ
85255-4814
US

V. Phone/Fax

Practice location:
  • Phone: 480-389-4215
  • Fax: 480-383-6199
Mailing address:
  • Phone: 480-389-4215
  • Fax: 480-383-6199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License NumberD8784
License Number StateAZ

VIII. Authorized Official

Name: SARA BUKHARI
Title or Position: PRESIDENT
Credential: DDS
Phone: 480-389-4215