Provider Demographics
NPI:1043541402
Name:SAWAQED, TARIQ (DDS)
Entity Type:Individual
Prefix:
First Name:TARIQ
Middle Name:
Last Name:SAWAQED
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 1:3073 W 109TH PL
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-6825
Mailing Address - Country:US
Mailing Address - Phone:720-347-1162
Mailing Address - Fax:
Practice Address - Street 1:84 GARRISON ST STE A
Practice Address - Street 2:SUITE 240A
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-7427
Practice Address - Country:US
Practice Address - Phone:303-233-1112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN-100981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice