Healthcare Provider Details

I. General information

NPI: 1154241719
Provider Name (Legal Business Name): SARAH SUMIDA OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 JOHNSON FERRY RD UNIT 130
SANDY SPRINGS GA
30342-1709
US

IV. Provider business mailing address

2630 CRESCENT CLUB DR
HIXSON TN
37343-4517
US

V. Phone/Fax

Practice location:
  • Phone: 404-953-4034
  • Fax:
Mailing address:
  • Phone: 423-693-5540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT003750
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: