MEDICARE: DR. SUMEET MASAUN DDS

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	63628	CA

General Provider Information

NPI Number	:	1093122574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUMEET MASAUN DDS

Provider Business Mailing Address
First Line	:	42801 EVERGLADES PARK DR
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94538-3977
Country	:	US
Telephone Number	:	510-387-4344
Fax Number	:

Provider Business Practice Location Address
First Line	:	42801 EVERGLADES PARK DR
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94538-3977
Country	:	US
Telephone Number	:	510-387-4344
Fax Number	:

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

Provider Enumeration Date	:	07/17/2014
Last Update Date	:	07/17/2014

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Directions to “ DR. SUMEET MASAUN DDS” Practice Location

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