Provider Demographics
NPI:1902543101
Name:KOURY, SARAH EMILY (DMD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:EMILY
Last Name:KOURY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 FOREST AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-1730
Mailing Address - Country:US
Mailing Address - Phone:804-893-8715
Mailing Address - Fax:804-285-1292
Practice Address - Street 1:6900 FOREST AVE STE 110
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1730
Practice Address - Country:US
Practice Address - Phone:804-893-8715
Practice Address - Fax:804-285-1292
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAPENDING122300000X
VA0442000448122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist