Provider Demographics
NPI:1851918270
Name:SAHA, MOUMITA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MOUMITA
Middle Name:
Last Name:SAHA
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 1:7314 S GARNETT RD APT 431
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-8687
Mailing Address - Country:US
Mailing Address - Phone:580-222-6776
Mailing Address - Fax:
Practice Address - Street 1:2145 S SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74129-1001
Practice Address - Country:US
Practice Address - Phone:918-948-6965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK73321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice