MEDICARE: DR. ARMIN MEHDIZADEH-SHRIFI DDS

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
1	122300000X	Dentist	DS045501	PA
2	122300000X	Dentist	41641	TX

General Provider Information

NPI Number	:	1033957204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARMIN MEHDIZADEH-SHRIFI DDS

Provider Business Mailing Address
First Line	:	3223 N BROAD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-5007
Country	:	US
Telephone Number	:	210-552-2199
Fax Number	:

Provider Business Practice Location Address
First Line	:	545 N BROAD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19123-3592
Country	:	US
Telephone Number	:	215-874-7611
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2024
Last Update Date	:	03/09/2026

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