1154491751 NPI number — DR. SARAH J IQBAL DMD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154491751 NPI number — DR. SARAH J IQBAL DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
IQBAL
Provider First Name:
SARAH
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
IQBAL NASH
Provider Other First Name:
SARAH
Provider Other Middle Name:
J
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1154491751
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
132 N SECOND STREET
Provider Second Line Business Mailing Address:
DANVILLE FAMILY DENTISTRY
Provider Business Mailing Address City Name:
DANVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40422
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-236-2488
Provider Business Mailing Address Fax Number:
859-236-1647

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
132 N SECOND STREET
Provider Second Line Business Practice Location Address:
DANVILLE FAMILY DENTISTRY
Provider Business Practice Location Address City Name:
DANVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40422
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-236-2488
Provider Business Practice Location Address Fax Number:
859-236-1647
Provider Enumeration Date:
11/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  7005 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 60070059 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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