Healthcare Provider Details

I. General information

NPI: 1508318684
Provider Name (Legal Business Name): SACHIN SAHARAN DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 04/27/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44249 20TH ST W
LANCASTER CA
93534
US

IV. Provider business mailing address

44249 20TH ST W
LANCASTER CA
93534
US

V. Phone/Fax

Practice location:
  • Phone: 661-723-1461
  • Fax: 661-942-7082
Mailing address:
  • Phone: 661-723-1461
  • Fax: 661-942-7082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number53191
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number54913
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number61057
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number56196
License Number StateCA

VIII. Authorized Official

Name: SACHIN SAHARAN
Title or Position: MANGING DENTIST
Credential: DDS
Phone: 661-723-1461