Provider Demographics
NPI:1023498797
Name:SARAWAGI, CHHAMA (DDS)
Entity type:Individual
Prefix:DR
First Name:CHHAMA
Middle Name:
Last Name:SARAWAGI
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:NAVAL HOSPITAL TWENTYNINE PALMS
Mailing Address - Street 2:1145 STURGIS RD
Mailing Address - City:TWENTYNINE PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92278
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:86 W ESPERANZA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-2879
Practice Address - Country:US
Practice Address - Phone:520-625-7790
Practice Address - Fax:520-339-6768
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9428317-9921122300000X
VA04014169441223S0112X
KS620231223S0112X
CA1083311223S0112X
AZD0120961223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist