Provider Demographics
NPI:1164873485
Name:SARDENBERG, JULIANA (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:JULIANA
Middle Name:
Last Name:SARDENBERG
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:JULIANA
Other - Middle Name:
Other - Last Name:SARDEMBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2036 N PROSPECT AVE UNIT 1204
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-1263
Mailing Address - Country:US
Mailing Address - Phone:954-204-1848
Mailing Address - Fax:
Practice Address - Street 1:20350 WATER TOWER BLVD
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-3558
Practice Address - Country:US
Practice Address - Phone:262-327-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN222431223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics