1801204532 NPI number — DR. SAROJ KUMAR SAHA DDS MSD

Table of content: DR. SAROJ KUMAR SAHA DDS MSD (NPI 1801204532)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801204532 NPI number — DR. SAROJ KUMAR SAHA DDS MSD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAHA
Provider First Name:
SAROJ
Provider Middle Name:
KUMAR
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS MSD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SAHA
Provider Other First Name:
SAROJ
Provider Other Middle Name:
KUMAR
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1801204532
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/19/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
830 S EMERSON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80209-4343
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
309-657-6665
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
682 S EMERSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80209-4339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
309-657-6665
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/25/2014

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: 1223P0300X , with the licence number:  D0202085 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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