Provider Demographics
NPI:1346672920
Name:MANDELL, SARA ELIZABETH (DMD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:ELIZABETH
Last Name:MANDELL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 N VISTA RIDGE BLVD STE SUITE700
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7637
Mailing Address - Country:US
Mailing Address - Phone:512-402-7811
Mailing Address - Fax:512-777-4076
Practice Address - Street 1:920 N VISTA RIDGE BLVD STE SUITE700
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7637
Practice Address - Country:US
Practice Address - Phone:512-402-7811
Practice Address - Fax:512-777-4076
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18562881223G0001X
TX369171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice