MEDICARE: DR. SARVENAZ SHARIFI 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	1223G0001X	General Practice Dentistry	60071	CA

General Provider Information

NPI Number	:	1740584242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARVENAZ SHARIFI DDS

Provider Business Mailing Address
First Line	:	19888 PROSPECT RD
Second Line	:	SUITE B
City	:	SARATOGA
State	:	CA
Zip	:	95070-3155
Country	:	US
Telephone Number	:	408-252-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	19888 PROSPECT RD
Second Line	:	SUITE B
City	:	SARATOGA
State	:	CA
Zip	:	95070-3155
Country	:	US
Telephone Number	:	408-252-6000
Fax Number	:

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

Provider Enumeration Date	:	12/28/2010
Last Update Date	:	12/28/2010

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