Provider Demographics
NPI:1871261057
Name:SOBHANI, SARA (DDS)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:SOBHANI
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 1:12670 120TH AVE NE APT 604
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7519
Mailing Address - Country:US
Mailing Address - Phone:310-755-1217
Mailing Address - Fax:
Practice Address - Street 1:10640 16TH AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98146-2076
Practice Address - Country:US
Practice Address - Phone:877-378-4899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61167362122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist