Provider Demographics
NPI:1639376056
Name:NADERI, SARA (DDS)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:NADERI
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 1:8331 CRAWFORDSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46234-1715
Mailing Address - Country:US
Mailing Address - Phone:317-293-1418
Mailing Address - Fax:
Practice Address - Street 1:55 BRENDON WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-1961
Practice Address - Country:US
Practice Address - Phone:317-873-6750
Practice Address - Fax:317-873-6708
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010701A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice