Provider Demographics
NPI:1194811455
Name:GANJAVI, SARAH SAGHI (DDS)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:SAGHI
Last Name:GANJAVI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:GANJAVI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:301 MAPLE AVE W
Mailing Address - Street 2:SUITE 400
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4308
Mailing Address - Country:US
Mailing Address - Phone:703-938-6600
Mailing Address - Fax:703-938-7030
Practice Address - Street 1:301 MAPLE AVE W
Practice Address - Street 2:SUITE 400
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4308
Practice Address - Country:US
Practice Address - Phone:703-938-6600
Practice Address - Fax:703-938-7030
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD119101223P0221X
VA04010089391223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry