Provider Demographics
NPI:1386029270
Name:PAYDAR, SARMAD (DDS MS)
Entity Type:Individual
Prefix:
First Name:SARMAD
Middle Name:
Last Name:PAYDAR
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 L ST # 684
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814-3805
Mailing Address - Country:US
Mailing Address - Phone:916-834-6837
Mailing Address - Fax:
Practice Address - Street 1:1017 L ST # 684
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-3805
Practice Address - Country:US
Practice Address - Phone:916-834-6837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-21
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA637791223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics