Provider Demographics
NPI:1477835486
Name:SANDS, JAMIE ELIZABETH (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:ELIZABETH
Last Name:SANDS
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 1:12840 RIVERSIDE DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91607
Mailing Address - Country:US
Mailing Address - Phone:818-766-6767
Mailing Address - Fax:
Practice Address - Street 1:12840 RIVERSIDE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91607-3327
Practice Address - Country:US
Practice Address - Phone:818-766-6767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45769122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist