Provider Demographics
NPI:1164514188
Name:SARABIA, NICASIO (DDS)
Entity Type:Individual
Prefix:DR
First Name:NICASIO
Middle Name:
Last Name:SARABIA
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:PO BOX 3329
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93278-3329
Mailing Address - Country:US
Mailing Address - Phone:559-737-2507
Mailing Address - Fax:
Practice Address - Street 1:3404 E VASSAR CT
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93292-9774
Practice Address - Country:US
Practice Address - Phone:559-737-2507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31891122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist