Provider Demographics
NPI:1679627095
Name:CUPINO, SARAH (DDS)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:CUPINO
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 1:12146 SOUTH ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-6844
Mailing Address - Country:US
Mailing Address - Phone:562-924-1007
Mailing Address - Fax:562-924-1267
Practice Address - Street 1:12146 SOUTH ST
Practice Address - Street 2:SUITE E
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-6844
Practice Address - Country:US
Practice Address - Phone:562-924-1007
Practice Address - Fax:562-924-1267
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41910122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist