Provider Demographics
NPI:1528559721
Name:GOMENDI, SARA (ND)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:GOMENDI
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11918 S BIRCH AVE
Mailing Address - Street 2:
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037-3363
Mailing Address - Country:US
Mailing Address - Phone:918-995-7001
Mailing Address - Fax:
Practice Address - Street 1:9224 S ELWOOD AVE STE B
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-2383
Practice Address - Country:US
Practice Address - Phone:918-995-7001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath