Provider Demographics
NPI:1831283423
Name:TAURAS, SARUNAS PETER (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARUNAS
Middle Name:PETER
Last Name:TAURAS
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 1:8691CONNECTICUT STREET
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6287
Mailing Address - Country:US
Mailing Address - Phone:219-757-5700
Mailing Address - Fax:219-757-5706
Practice Address - Street 1:8691CONNECTICUT STREET
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6287
Practice Address - Country:US
Practice Address - Phone:219-757-5700
Practice Address - Fax:219-757-5706
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120071111223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
INT34729Medicare UPIN
IN385080AMedicare ID - Type Unspecified