Provider Demographics
NPI:1740779933
Name:FARID, SARA (DMD)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:
Last Name:FARID
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 HAVERSTRAW RD
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-2900
Mailing Address - Country:US
Mailing Address - Phone:845-608-9413
Mailing Address - Fax:
Practice Address - Street 1:515 ROUTE 304
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3037
Practice Address - Country:US
Practice Address - Phone:845-608-9413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02743600122300000X
NY060585122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist