Provider Demographics
NPI:1417572983
Name:SAREMI, SABA
Entity Type:Individual
Prefix:
First Name:SABA
Middle Name:
Last Name:SAREMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:568 KRISTEN CT
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2788
Mailing Address - Country:US
Mailing Address - Phone:310-666-3932
Mailing Address - Fax:
Practice Address - Street 1:568 KRISTEN CT
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2788
Practice Address - Country:US
Practice Address - Phone:310-666-3932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2023-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1068191223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics