Healthcare Provider Details

I. General information

NPI: 1659296796
Provider Name (Legal Business Name): SARAH DARST DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8635 W 3RD ST STE 255
LOS ANGELES CA
90048-6113
US

IV. Provider business mailing address

1419 PEERLESS PL APT 317
LOS ANGELES CA
90035-2866
US

V. Phone/Fax

Practice location:
  • Phone: 503-580-1033
  • Fax:
Mailing address:
  • Phone: 503-580-1033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: SARAH ELYASNIK
Title or Position: OWNER
Credential: DDS
Phone: 310-659-8863