Provider Demographics
NPI:1508241084
Name:DREXLER, SASHA NOURI (DDS)
Entity Type:Individual
Prefix:DR
First Name:SASHA
Middle Name:NOURI
Last Name:DREXLER
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 1:1460 POST RD E
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5500
Mailing Address - Country:US
Mailing Address - Phone:314-609-0271
Mailing Address - Fax:
Practice Address - Street 1:1460 POST RD E
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880
Practice Address - Country:US
Practice Address - Phone:203-254-8008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00202615122300000X
CT011693122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT011693OtherCONNECTICUT STATE DENTAL LICENSE
CT011693OtherCONNECTICUT STATE DENTAL LICENSE