Provider Demographics
NPI:1578906194
Name:SANDERS, STEVEN CARL (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CARL
Last Name:SANDERS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9941 MCBROOM ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-1657
Mailing Address - Country:US
Mailing Address - Phone:818-243-4287
Mailing Address - Fax:
Practice Address - Street 1:428 ARDEN AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-1108
Practice Address - Country:US
Practice Address - Phone:818-243-4287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-12
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA219431223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics