Healthcare Provider Details

I. General information

NPI: 1215925540
Provider Name (Legal Business Name): SARA J PAIGE DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1119 S CENTERVILLE RD
STURGIS MI
49091-2094
US

IV. Provider business mailing address

1119 S CENTERVILLE RD
STURGIS MI
49091-2094
US

V. Phone/Fax

Practice location:
  • Phone: 269-319-5640
  • Fax:
Mailing address:
  • Phone: 269-319-5640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12013493A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901603319
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: