Provider Demographics
NPI:1831346626
Name:SADRI, KATAYOUN (DDS)
Entity type:Individual
Prefix:DR
First Name:KATAYOUN
Middle Name:
Last Name:SADRI
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 1:2741 CAMPUS WALK AVE. STE 300
Mailing Address - Street 2:CAMPUS WALK DENTAL CARE
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-8878
Mailing Address - Country:US
Mailing Address - Phone:919-908-8386
Mailing Address - Fax:919-908-8387
Practice Address - Street 1:2741 CAMPUS WALK AVE. STE 300
Practice Address - Street 2:CAMPUS WALK DENTAL CARE
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-8878
Practice Address - Country:US
Practice Address - Phone:919-908-8386
Practice Address - Fax:919-908-8387
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-22
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7803122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist