Healthcare Provider Details

I. General information

NPI: 1780432989
Provider Name (Legal Business Name): SARA SANJARI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2024
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 SUTTER ST RM 1519
SAN FRANCISCO CA
94108-4004
US

IV. Provider business mailing address

450 SUTTER ST RM 1519
SAN FRANCISCO CA
94108-4004
US

V. Phone/Fax

Practice location:
  • Phone: 312-451-8007
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI03044600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number111545
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: