Provider Demographics
NPI:1225799240
Name:SARA TAJZIEHCHI, DDS , A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:SARA TAJZIEHCHI, DDS , A PROFESSIONAL CORPORATION
Other - Org Name:DENTIQUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAJZIEHCHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:747-900-6024
Mailing Address - Street 1:5777 LAS VIRGENES RD STE A
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1275
Mailing Address - Country:US
Mailing Address - Phone:747-900-6024
Mailing Address - Fax:
Practice Address - Street 1:5777 LAS VIRGENES RD STE A
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1275
Practice Address - Country:US
Practice Address - Phone:747-900-6024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-02
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty