Provider Demographics
NPI:1295308930
Name:IMRAN, SADAF (DDS)
Entity type:Individual
Prefix:DR
First Name:SADAF
Middle Name:
Last Name:IMRAN
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 1:13536 S ALDEN ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-5840
Mailing Address - Country:US
Mailing Address - Phone:913-355-2634
Mailing Address - Fax:
Practice Address - Street 1:13536 S ALDEN ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-5840
Practice Address - Country:US
Practice Address - Phone:913-355-2634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS618581223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice