MEDICARE: DR. SHARILYN T. MONIZ 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	61296	CA

General Provider Information

NPI Number	:	1881717882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARILYN T. MONIZ DDS

Provider Business Mailing Address
First Line	:	13420 RUSSET LEAF LN
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92129-4410
Country	:	US
Telephone Number	:	505-363-9309
Fax Number	:

Provider Business Practice Location Address
First Line	:	3424 1ST AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-4802
Country	:	US
Telephone Number	:	619-230-5309
Fax Number	:	619-566-4408

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

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	09/18/2021

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