Provider Demographics
NPI:1407401458
Name:ASHNAGAR, SAJJAD (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:SAJJAD
Middle Name:
Last Name:ASHNAGAR
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 1:37 MADELON ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48111-2726
Mailing Address - Country:US
Mailing Address - Phone:734-262-5890
Mailing Address - Fax:
Practice Address - Street 1:800 W ARBROOK BLVD STE 360
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-4317
Practice Address - Country:US
Practice Address - Phone:817-774-9313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX356181223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty