Individual
SARA MASOUMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9669 N CENTRAL EXPY STE 290, DALLAS, TX 75231-5054
(214) 416-8700
Mailing address
15250 QUORUM DR APT 229, ADDISON, TX 75001-4632
(424) 426-8030
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
39898
TX
1223P0221X
Pediatric Dentistry
Primary
39898
TX
1223P0221X
Pediatric Dentistry
DDS113146
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/17/2023
Last updated
07/23/2026
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