MEDICARE: DR. AMANDA RAFI DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	D009533	AZ

General Provider Information

NPI Number	:	1003269671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA RAFI DMD

Provider Business Mailing Address
First Line	:	10201 N 124TH ST
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85259-5215
Country	:	US
Telephone Number	:	480-510-8888
Fax Number	:

Provider Business Practice Location Address
First Line	:	267 E BELL RD STE 3
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-6337
Country	:	US
Telephone Number	:	602-993-6000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2016
Last Update Date	:	07/19/2016

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