Provider Demographics
NPI:1093201782
Name:SADEGHINIA, DAVID (DDS)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:SADEGHINIA
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 1:5601 N ORACLE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-3980
Mailing Address - Country:US
Mailing Address - Phone:520-887-8771
Mailing Address - Fax:
Practice Address - Street 1:5601 N ORACLE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-3980
Practice Address - Country:US
Practice Address - Phone:520-887-8771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0596961223G0001X
AZD0104791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice