Provider Demographics
NPI:1851962542
Name:WATERS, SARAH (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:WATERS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:TRIBBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:950 WADSWORTH BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-4542
Mailing Address - Country:US
Mailing Address - Phone:303-237-3640
Mailing Address - Fax:
Practice Address - Street 1:950 WADSWORTH BLVD STE 207
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-4542
Practice Address - Country:US
Practice Address - Phone:303-237-3640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-05
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX373711223G0001X
CODEN.002049501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice