Provider Demographics
NPI:1689317703
Name:AL-NAZER, SARAH BAKER
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:BAKER
Last Name:AL-NAZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12303 CEDAR RD APT 439
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44106-3268
Mailing Address - Country:US
Mailing Address - Phone:440-990-6644
Mailing Address - Fax:
Practice Address - Street 1:9601 CHESTER AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1666
Practice Address - Country:US
Practice Address - Phone:216-368-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-16
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT13392390200000X
OHRES.0045581223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program