Healthcare Provider Details

I. General information

NPI: 1235973801
Provider Name (Legal Business Name): DAVOR SEFEROVIC DMD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2024
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 E GUADALUPE RD STE 108
GILBERT AZ
85234-5116
US

IV. Provider business mailing address

2450 E GUADALUPE RD STE 108
GILBERT AZ
85234-5116
US

V. Phone/Fax

Practice location:
  • Phone: 480-750-4433
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number40484
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD012702
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: