Provider Demographics
NPI:1720684061
Name:TARAR, SAAD MASOOD
Entity Type:Individual
Prefix:
First Name:SAAD
Middle Name:MASOOD
Last Name:TARAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11518 NEON RD
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5149
Mailing Address - Country:US
Mailing Address - Phone:925-434-7596
Mailing Address - Fax:
Practice Address - Street 1:1680 NW CHIPMAN RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-3934
Practice Address - Country:US
Practice Address - Phone:816-600-3722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105865122300000X
MO2022023827122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist