Provider Demographics
NPI:1992309280
Name:ALKHAZRAJI, SARAH A
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:ALKHAZRAJI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9910 NW 25TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-5192
Mailing Address - Country:US
Mailing Address - Phone:915-764-8539
Mailing Address - Fax:
Practice Address - Street 1:5021 NW 34TH BLVD STE A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-1191
Practice Address - Country:US
Practice Address - Phone:352-371-7766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-26
Last Update Date:2020-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH26279124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist