MEDICARE: DR. JYOTI SAGAR DMD

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	2901019191	MI
2	1223G0001X	General Practice Dentistry	30022458	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801970835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JYOTI SAGAR DMD

Provider Business Mailing Address
First Line	:	6849 PEARL RD # C
Second Line	:
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-3616
Country	:	US
Telephone Number	:	440-843-1500
Fax Number	:

Provider Business Practice Location Address
First Line	:	6849 PEARL RD # C
Second Line	:
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-3616
Country	:	US
Telephone Number	:	440-843-1500
Fax Number	:

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	11/07/2011

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