Provider Demographics
NPI:1902136872
Name:DEEN, SARA H (DDS)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:H
Last Name:DEEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9050 DOUBLE R BLVD
Mailing Address - Street 2:APT. 1525
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-4911
Mailing Address - Country:US
Mailing Address - Phone:775-851-8590
Mailing Address - Fax:
Practice Address - Street 1:9050 DOUBLE R BLVD
Practice Address - Street 2:APT. 1525
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-4911
Practice Address - Country:US
Practice Address - Phone:775-851-8590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-28
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54861122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist