Provider Demographics
NPI:1548743164
Name:HEETER, SARAH A (DDS)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:A
Last Name:HEETER
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 1:4 HERBERT ST STE A
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22305-2628
Mailing Address - Country:US
Mailing Address - Phone:573-881-2899
Mailing Address - Fax:
Practice Address - Street 1:4 HERBERT ST STE A
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22305-2628
Practice Address - Country:US
Practice Address - Phone:573-881-2899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2023-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7504122300000X
VA0401416497122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist