Provider Demographics
NPI:1326774654
Name:SANDLER, LAURA (RDH)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:SANDLER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2546 S GENESEE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-2412
Mailing Address - Country:US
Mailing Address - Phone:310-429-1062
Mailing Address - Fax:
Practice Address - Street 1:5400 BALBOA BLVD STE 315
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-5229
Practice Address - Country:US
Practice Address - Phone:818-990-5220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27547124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty