Provider Demographics
NPI:1003417296
Name:GARCIA, IRENE SAHARAI (RDH)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:SAHARAI
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 WATERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-2549
Mailing Address - Country:US
Mailing Address - Phone:561-460-4107
Mailing Address - Fax:
Practice Address - Street 1:1250 SOUTHWINDS DR
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-1459
Practice Address - Country:US
Practice Address - Phone:561-642-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH22330124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist