Healthcare Provider Details

I. General information

NPI: 1053623942
Provider Name (Legal Business Name): SARA NATASHA JEFFREY DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2010
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1293 ENCINITAS BLVD
ENCINITAS CA
92024-2843
US

IV. Provider business mailing address

1455 MISSOURI ST APT 1
SAN DIEGO CA
92109-3058
US

V. Phone/Fax

Practice location:
  • Phone: 760-944-8313
  • Fax:
Mailing address:
  • Phone: 929-422-8102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number112030
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: