Provider Demographics
NPI:1548377898
Name:SANAYEI, BERNA (DDS)
Entity type:Individual
Prefix:MRS
First Name:BERNA
Middle Name:
Last Name:SANAYEI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:BERNA
Other - Middle Name:O
Other - Last Name:LAZAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:499 GALEN DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123
Mailing Address - Country:US
Mailing Address - Phone:408-227-2223
Mailing Address - Fax:408-227-2223
Practice Address - Street 1:2929 THE VILLAGES PARKWAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95135
Practice Address - Country:US
Practice Address - Phone:408-274-9554
Practice Address - Fax:408-274-4320
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48178122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist