Individual provider Active NPI

Sarah Baker Al-Nazer

  • Periodontics
  • Cleveland, OH
National Provider Identifier
1689317703
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
RES.004558 Issued in OH
Practice address
9601 Chester Ave
Cleveland, OH 44106-1666
Phone
(216) 368-3200
NPI assigned
Apr 16, 2022
Last updated
Dec 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X RES.004558 OH Primary
Student in an Organized Health Care Education/Training Program 390200000X 13392 CT

Addresses

Primary practice location

9601 Chester Ave
Cleveland, OH 44106-1666

Mailing address

12303 Cedar Rd Apt 439
Cleveland Heights, OH 44106-3268
Phone (440) 990-6644

Other practice location 1

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220806000085 CT Order and Referring Only - DentistPractitioner - Dentist 9032591144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RES.004558OHMDPeriodontist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1650067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1689317703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12303 CEDAR RD APT 439",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441063268",
            "telephone_number": "440-990-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 CHESTER AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061666",
            "telephone_number": "216-368-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060300001",
            "country_code": "US",
            "telephone_number": "860-679-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-NAZER",
        "first_name": "SARAH",
        "middle_name": "BAKER",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-16",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "RES.004558",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": "13392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.