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NPI Code Detail

MEDICARE: SARAH E ALLEN DDS

MEDICARE:   SARAH E ALLEN  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
11223G0001XGeneral Practice Dentistry0401412532VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1095568OTHERVAANTHEM BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1245468156
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH E ALLEN DDS
Provider Business Mailing Address
First Line : 1542 E BAYVIEW BLVD
Second Line :
City : NORFOLK
State : VA
Zip : 23503-3255
Country : US
Telephone Number : 757-583-1212
Fax Number : 757-583-4722
Provider Business Practice Location Address
First Line : 1542 E BAYVIEW BLVD
Second Line :
City : NORFOLK
State : VA
Zip : 23503-3255
Country : US
Telephone Number : 757-583-1212
Fax Number : 757-583-4722
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2009
Last Update Date : 06/30/2009

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