Provider Demographics
NPI:1396391488
Name:BAKHIET, SARAH ABDEL FATTAH (DDS)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ABDEL FATTAH
Last Name:BAKHIET
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12770 MERIT DR STE 850
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-1438
Mailing Address - Country:US
Mailing Address - Phone:972-361-0600
Mailing Address - Fax:
Practice Address - Street 1:18851 UNIVERSITY BLVD STE 210
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-6818
Practice Address - Country:US
Practice Address - Phone:281-990-0685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX354211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX35421OtherDENTAL LICENSE