Provider Demographics
NPI:1164272506
Name:BILBY, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BILBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 BILBY HILL RD
Mailing Address - Street 2:
Mailing Address - City:SHICKSHINNY
Mailing Address - State:PA
Mailing Address - Zip Code:18655-4713
Mailing Address - Country:US
Mailing Address - Phone:570-991-8511
Mailing Address - Fax:
Practice Address - Street 1:114 BILBY HILL RD
Practice Address - Street 2:
Practice Address - City:SHICKSHINNY
Practice Address - State:PA
Practice Address - Zip Code:18655-4713
Practice Address - Country:US
Practice Address - Phone:570-991-8511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERDH4560124Q00000X
WI700112516124Q00000X
PADH074413124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist