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NPI Code Detail

MEDICARE: JERALD SCHARFENBERG DDS PC

MEDICARE: JERALD SCHARFENBERG DDS PC
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
11223G0001XGeneral Practice Dentistry1914976IL

General Provider Information

NPI Number : 1972730471
Entity Type Code : Organization
Provider Name (Legal Business Name) : JERALD SCHARFENBERG DDS PC
Provider Business Mailing Address
First Line : 135D N ADDISON AVE STE 240
Second Line :
City : ELMHURST
State : IL
Zip : 60126-2809
Country : US
Telephone Number : 630-279-3070
Fax Number :
Provider Business Practice Location Address
First Line : 135D N ADDISON AVE STE 240
Second Line :
City : ELMHURST
State : IL
Zip : 60126-2809
Country : US
Telephone Number : 630-279-3070
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. JERALD WALTER SCHARFENBERG
Credential : D.D.S.
Telephone Number : 630-279-3070
Provider Enumeration Date : 06/11/2009
Last Update Date : 06/11/2009

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