Provider Demographics
NPI:1487855730
Name:BHOR, SASHA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SASHA
Middle Name:
Last Name:BHOR
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 1:11611 RANCHO BERNARDO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-1412
Mailing Address - Country:US
Mailing Address - Phone:858-592-9500
Mailing Address - Fax:858-592-9504
Practice Address - Street 1:11611 RANCHO BERNARDO RD STE 103
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1412
Practice Address - Country:US
Practice Address - Phone:858-592-9500
Practice Address - Fax:858-592-9504
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52041122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD52041Medicaid