Provider Demographics
NPI:1609082908
Name:SACKS, DARREN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARREN
Middle Name:
Last Name:SACKS
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 1:18 DANA DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:07848-4448
Mailing Address - Country:US
Mailing Address - Phone:973-222-6806
Mailing Address - Fax:
Practice Address - Street 1:39 NEWTON SPARTA RD
Practice Address - Street 2:BLDG # A
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2773
Practice Address - Country:US
Practice Address - Phone:973-383-4421
Practice Address - Fax:973-300-9075
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ188501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice