Provider Demographics
NPI:1831861749
Name:HUSSEIN, SAHAR (DDS)
Entity type:Individual
Prefix:
First Name:SAHAR
Middle Name:
Last Name:HUSSEIN
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:SAHAR HUSSEIN
Mailing Address - Street 2:1902 GREEN JASPER PLACE
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76005
Mailing Address - Country:US
Mailing Address - Phone:309-569-9057
Mailing Address - Fax:
Practice Address - Street 1:5334 N TARRANT PKWY
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6293
Practice Address - Country:US
Practice Address - Phone:817-500-5733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-29
Last Update Date:2021-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX376871223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty