Provider Demographics
NPI:1144649815
Name:NAIROOZ, SANDRA (DDS)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:NAIROOZ
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 1:2907 N LOOP 1604 E # 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1718
Mailing Address - Country:US
Mailing Address - Phone:210-905-9000
Mailing Address - Fax:
Practice Address - Street 1:2907 N LOOP 1604 E # 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1718
Practice Address - Country:US
Practice Address - Phone:210-905-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2023-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29111122300000X, 1223G0001X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice