Provider Demographics
NPI:1659439289
Name:WARD, SARA J (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:J
Last Name:WARD
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 1:2080 CENTURY PARK E
Mailing Address - Street 2:SUITE 1803
Mailing Address - City:CENTURY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2001
Mailing Address - Country:US
Mailing Address - Phone:310-553-2288
Mailing Address - Fax:310-553-1612
Practice Address - Street 1:2080 CENTURY PARK E
Practice Address - Street 2:SUITE 1803
Practice Address - City:CENTURY CITY
Practice Address - State:CA
Practice Address - Zip Code:90067-2001
Practice Address - Country:US
Practice Address - Phone:310-553-2288
Practice Address - Fax:310-553-1612
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA288271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice