Provider Demographics
NPI:1770076721
Name:KAKADIA, SAGAR (DDS)
Entity type:Individual
Prefix:DR
First Name:SAGAR
Middle Name:
Last Name:KAKADIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 CLIFFORD AVE
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:GA
Mailing Address - Zip Code:30467-2012
Mailing Address - Country:US
Mailing Address - Phone:912-564-7107
Mailing Address - Fax:
Practice Address - Street 1:1755 WOODSTOCK RD STE 100
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2135
Practice Address - Country:US
Practice Address - Phone:770-993-6893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0156781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice