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General NPI Number Information
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NPI Number | 1356630685
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Entity Type | Individual
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Provider Name | SHERRY FAUST DDS
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Gender | Female
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Dates
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Enumeration Date | 04/07/2011
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Last Update Date | 04/07/2011
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Provider Practice Location Address
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Address Line | UNIV OF S CALIF SCHOOL OF DENTISTRY 925 W.34TH ST. RM. # 4208
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City | LOS ANGELES
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State | CA
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Zip | 90089-0001
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Country | US
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Telephone | 213-821-6814
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Fax |
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Provider Business Mailing Address
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Address Line | 6514 ABBOTTSWOOD DR
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-3106
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Country | US
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Telephone | 213-821-6814
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 27428
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License Number State | CA
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