MEDICARE: SARA ALKHATIB DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12013754A	IN

General Provider Information

NPI Number	:	1205404381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA ALKHATIB DDS

Provider Business Mailing Address
First Line	:	11683 FOX RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46236-8423
Country	:	US
Telephone Number	:	317-826-4347
Fax Number	:

Provider Business Practice Location Address
First Line	:	11683 FOX RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46236-8423
Country	:	US
Telephone Number	:	317-826-4347
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2021
Last Update Date	:	09/21/2022

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Directions to “ SARA ALKHATIB DDS” Practice Location

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