Provider Demographics
NPI:1306935945
Name:SANAI, YASAMAN (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:YASAMAN
Middle Name:
Last Name:SANAI
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 NE FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311-3005
Mailing Address - Country:US
Mailing Address - Phone:360-377-3272
Mailing Address - Fax:360-782-2658
Practice Address - Street 1:1275 NE FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98311-3005
Practice Address - Country:US
Practice Address - Phone:360-377-3272
Practice Address - Fax:360-782-2658
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA86271223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics