Provider Demographics
NPI:1669958336
Name:ZANGENEH, SARA (RDH)
Entity type:Individual
Prefix:MISS
First Name:SARA
Middle Name:
Last Name:ZANGENEH
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:MRS
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:GLOTZBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:612 S CLAY ST
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66441-3605
Mailing Address - Country:US
Mailing Address - Phone:785-917-0140
Mailing Address - Fax:
Practice Address - Street 1:612 S CLAY ST
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:KS
Practice Address - Zip Code:66441-3605
Practice Address - Country:US
Practice Address - Phone:785-917-0140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2024-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12298124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist