Provider Demographics
NPI:1073500567
Name:SANDERS, JOHN A (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:SANDERS
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 1:17222 RED OAK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2614
Mailing Address - Country:US
Mailing Address - Phone:281-444-5229
Mailing Address - Fax:281-444-5688
Practice Address - Street 1:17222 RED OAK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2648
Practice Address - Country:US
Practice Address - Phone:281-444-5229
Practice Address - Fax:281-444-5688
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice