Provider Demographics
NPI:1972621985
Name:SAHASI, PREETI (DMD)
Entity type:Individual
Prefix:
First Name:PREETI
Middle Name:
Last Name:SAHASI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 TRIVETTE DR STE 303
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-1275
Mailing Address - Country:US
Mailing Address - Phone:606-437-9601
Mailing Address - Fax:606-437-1315
Practice Address - Street 1:126 TRIVETTE DR STE 303
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1275
Practice Address - Country:US
Practice Address - Phone:606-437-9601
Practice Address - Fax:606-437-1315
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY85771223G0001X
WV41221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000000258208OtherDENTAL BENEFIT PROVIDERS
PA0019759810002Medicaid
169273OtherUNISON UNITED HEALTHCARE
KY7100170730Medicaid