Healthcare Provider Details

I. General information

NPI: 1245460492
Provider Name (Legal Business Name): SHARI ANN FIFE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2009
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 PROFESSIONAL DR
SACRAMENTO CA
95825-2106
US

IV. Provider business mailing address

1801 PROFESSIONAL DR
SACRAMENTO CA
95825-2106
US

V. Phone/Fax

Practice location:
  • Phone: 916-974-1160
  • Fax: 916-974-1163
Mailing address:
  • Phone: 916-974-1160
  • Fax: 916-974-1163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number39545
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: