Provider Demographics
NPI:1427622745
Name:GAJENDRAN SARAH, SANGEETHA (BDS,MDS,MHA)
Entity type:Individual
Prefix:DR
First Name:SANGEETHA
Middle Name:
Last Name:GAJENDRAN SARAH
Suffix:
Gender:F
Credentials:BDS,MDS,MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8585 WOODWAY DR APT 237
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2440
Mailing Address - Country:US
Mailing Address - Phone:832-461-7041
Mailing Address - Fax:
Practice Address - Street 1:5819 GULF FWY STE 600
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77023-5353
Practice Address - Country:US
Practice Address - Phone:713-325-5180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37156122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist