Provider Demographics
NPI:1134932940
Name:HASHAM, SARA (DMD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HASHAM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:HASHAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:5829 SPERRY DR
Mailing Address - Street 2:
Mailing Address - City:CITRUS HTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-6478
Mailing Address - Country:US
Mailing Address - Phone:916-475-3207
Mailing Address - Fax:
Practice Address - Street 1:800 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-1443
Practice Address - Country:US
Practice Address - Phone:916-475-3207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-02-05
Deactivation Date:2025-01-30
Deactivation Code:
Reactivation Date:2025-02-05
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program