MEDICARE: DR. YASER SARFARAZ 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	15104	MD

General Provider Information

NPI Number	:	1609123991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YASER SARFARAZ DDS

Provider Business Mailing Address
First Line	:	14337 GEORGIA AVE APT 202
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-2784
Country	:	US
Telephone Number	:	301-256-8646
Fax Number	:

Provider Business Practice Location Address
First Line	:	12114 GEORGIA AVE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-5522
Country	:	US
Telephone Number	:	301-942-5500
Fax Number	:

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

Provider Enumeration Date	:	08/06/2012
Last Update Date	:	08/06/2012

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