Provider Demographics
NPI:1952738296
Name:TAJ, SARA (DDS)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:TAJ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:TAJZIEHCHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:5777 LAS VIRGENES RD STE A
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1275
Mailing Address - Country:US
Mailing Address - Phone:310-734-9096
Mailing Address - Fax:
Practice Address - Street 1:5777 LAS VIRGENES RD STE A
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1275
Practice Address - Country:US
Practice Address - Phone:747-900-6024
Practice Address - Fax:747-900-6029
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-01
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62964122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist