Healthcare Provider Details

I. General information

NPI: 1124799408
Provider Name (Legal Business Name): FAY NAZARI, DDS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2021
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7161 WALERGA RD
SACRAMENTO CA
95842-4621
US

IV. Provider business mailing address

7161 WALERGA RD
SACRAMENTO CA
95842-4621
US

V. Phone/Fax

Practice location:
  • Phone: 916-338-1600
  • Fax: 916-338-0151
Mailing address:
  • Phone: 916-338-1600
  • Fax: 916-338-0151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: FAY NAZARI
Title or Position: DENTIST
Credential: DDS
Phone: 410-707-3028