Provider Demographics
NPI:1073767828
Name:BELDERES, SARAH KATHRYN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:KATHRYN
Last Name:BELDERES
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 1:25500 RANCHO NIGUEL RD
Mailing Address - Street 2:STE 210
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-7302
Mailing Address - Country:US
Mailing Address - Phone:949-215-5500
Mailing Address - Fax:
Practice Address - Street 1:25500 RANCHO NIGUEL RD
Practice Address - Street 2:STE 210
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-7302
Practice Address - Country:US
Practice Address - Phone:949-215-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48580122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist