Provider Demographics
NPI:1902666720
Name:AL KARADAGHI, TAMARA SARDAR (DDS)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:SARDAR
Last Name:AL KARADAGHI
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 1:28702 NE 155TH ST
Mailing Address - Street 2:
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019-8021
Mailing Address - Country:US
Mailing Address - Phone:425-877-5181
Mailing Address - Fax:
Practice Address - Street 1:3800 BYRON AVE STE 100
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-2877
Practice Address - Country:US
Practice Address - Phone:360-389-4784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE614442951223S0112X, 1223X2210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X2210XDental ProvidersDentistOrofacial Pain
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery