Healthcare Provider Details

I. General information

NPI: 1538005434
Provider Name (Legal Business Name): MAHSA SADRI DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1844 E 9400 S
SANDY UT
84093-3000
US

IV. Provider business mailing address

152 E MIDVILLAGE BLVD APT 108
SANDY UT
84070-1374
US

V. Phone/Fax

Practice location:
  • Phone: 801-386-8793
  • Fax:
Mailing address:
  • Phone: 818-961-4976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14282347-9926
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: