Healthcare Provider Details

I. General information

NPI: 1336222389
Provider Name (Legal Business Name): SARAH DEMARCO DAVIES DDS, MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH DEMARCO DDS,MD

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E 1ST AVE STE A
TARENTUM PA
15084-1858
US

IV. Provider business mailing address

5820 CENTRE AVE STE 200
PITTSBURGH PA
15206-3710
US

V. Phone/Fax

Practice location:
  • Phone: 724-224-4463
  • Fax: 724-224-8041
Mailing address:
  • Phone: 412-661-7690
  • Fax: 412-661-7695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberMD433912
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberOMS 66
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberDS031505L
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS031505-L
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberA93976
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: