Provider Demographics
NPI:1073971248
Name:SADAGHIANI, JOHN R (DDS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:R
Last Name:SADAGHIANI
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 1:2825 LANCASTER RD.
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023
Mailing Address - Country:US
Mailing Address - Phone:614-554-7000
Mailing Address - Fax:740-321-1310
Practice Address - Street 1:45 N. WILSON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204
Practice Address - Country:US
Practice Address - Phone:614-351-9378
Practice Address - Fax:740-321-1310
Is Sole Proprietor?:No
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.018788122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist