Healthcare Provider Details

I. General information

NPI: 1912683806
Provider Name (Legal Business Name): SARA AMMAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 ATLANTIC AVE
BROOKLYN NY
11213-1122
US

IV. Provider business mailing address

1545 ATLANTIC AVE
BROOKLYN NY
11213-1122
US

V. Phone/Fax

Practice location:
  • Phone: 212-998-9800
  • Fax:
Mailing address:
  • Phone: 718-613-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number1912683806
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: