MEDICARE: DR. SARA ASHRAF RAFAIL 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	37724	TX
2	122300000X	Dentist	DN122610	GA

General Provider Information

NPI Number	:	1134894942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARA ASHRAF RAFAIL DDS

Provider Business Mailing Address
First Line	:	6500 ARIA BLVD APT 368
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-3675
Country	:	US
Telephone Number	:	832-557-5854
Fax Number	:

Provider Business Practice Location Address
First Line	:	3752 CASCADE RD SW STE 190
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-2149
Country	:	US
Telephone Number	:	678-263-3540
Fax Number	:

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

Provider Enumeration Date	:	08/12/2021
Last Update Date	:	04/05/2022

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