Provider Demographics
NPI:1053521013
Name:PURPS, SABINE ANITA (DDS)
Entity type:Individual
Prefix:DR
First Name:SABINE
Middle Name:ANITA
Last Name:PURPS
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 1:1764 SAN DIEGO AVE
Mailing Address - Street 2:#130
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-1987
Mailing Address - Country:US
Mailing Address - Phone:619-295-6500
Mailing Address - Fax:619-295-6509
Practice Address - Street 1:1764 SAN DIEGO AVE
Practice Address - Street 2:#130
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-1987
Practice Address - Country:US
Practice Address - Phone:619-295-6500
Practice Address - Fax:619-295-6509
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2471571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA330954348OtherTAX IDENTIFICATION