Provider Demographics
NPI:1497899736
Name:JELOKHANI MOKRY, SABA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SABA
Middle Name:
Last Name:JELOKHANI MOKRY
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 1:209 SIR WALKER LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-5511
Mailing Address - Country:US
Mailing Address - Phone:919-815-7334
Mailing Address - Fax:
Practice Address - Street 1:209 SIR WALKER LN
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-5511
Practice Address - Country:US
Practice Address - Phone:919-815-7334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC60471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8994571Medicaid
NCU38093Medicare UPIN