Healthcare Provider Details

I. General information

NPI: 1104652783
Provider Name (Legal Business Name): SARANG & MAHAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1711 61ST AVE STE 108
GREELEY CO
80634-3046
US

IV. Provider business mailing address

9568 W 56TH PL
ARVADA CO
80002-2108
US

V. Phone/Fax

Practice location:
  • Phone: 970-515-6332
  • Fax:
Mailing address:
  • Phone: 720-899-6394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: FRIA KOH
Title or Position: OFFICE MANAGER
Credential: RDH
Phone: 720-899-6394