Provider Demographics
NPI:1033634274
Name:AMIN, SAGAR D (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAGAR
Middle Name:D
Last Name:AMIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5114 MEDICAL DR APT 2350
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3878
Mailing Address - Country:US
Mailing Address - Phone:423-505-5922
Mailing Address - Fax:
Practice Address - Street 1:17910 BULVERDE RD STE 112
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-3762
Practice Address - Country:US
Practice Address - Phone:210-494-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-09
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX334651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice