Provider Demographics
NPI:1124436878
Name:CHILMERAN, SARAH (DDS)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:CHILMERAN
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 1:6000 BLOSSOM CT
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-7229
Mailing Address - Country:US
Mailing Address - Phone:469-450-8558
Mailing Address - Fax:
Practice Address - Street 1:1848 COMMERCENTER E
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3406
Practice Address - Country:US
Practice Address - Phone:909-382-0255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-25
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX301971223G0001X
CA1045041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA104504OtherDENTAL LICENSE