Sarah Bahar Behmanesh, DDS
Individual provider Active NPI Dentist · Lockhart, TX
NPI 1104059690 · NPPES record last updated Jan 31, 2011
Key facts
- NPI
- 1104059690
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 25213 (TX)
- Practice address
- 1711 S Colorado St
Lockhart, TX 78644-4615 - Phone
- (617) 784-9197
- NPI assigned
- Aug 31, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25213 | TX | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 25213 | TX | Yes |
Addresses
Primary practice location
1711 S Colorado St
Lockhart, TX 78644-4615
Mailing address
22800 Bulverde Rd Apt 4201
San Antonio, TX 78261-3075
Phone (617) 784-9197
Other providers in Lockhart, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.