Provider Demographics
NPI:1033232525
Name:SHAHNAVAZ, SARA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:SHAHNAVAZ
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 1:400 EL CERRO BLVD
Mailing Address - Street 2:SUITE #101
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-1731
Mailing Address - Country:US
Mailing Address - Phone:925-837-3090
Mailing Address - Fax:925-837-6419
Practice Address - Street 1:400 EL CERRO BLVD
Practice Address - Street 2:SUITE #101
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-1731
Practice Address - Country:US
Practice Address - Phone:925-837-3090
Practice Address - Fax:925-837-6419
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA481811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice