MEDICARE: AMER SAFADID.M.D,INC

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	261QD0000X	Dental Clinic/Center	33363	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184741928
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMER SAFADID.M.D,INC

Provider Business Mailing Address
First Line	:	6940 SANTA TERESA BLVD
Second Line	:	SUITE#4
City	:	SAN JOSE
State	:	CA
Zip	:	95119-1345
Country	:	US
Telephone Number	:	408-972-2811
Fax Number	:	408-972-2836

Provider Business Practice Location Address
First Line	:	6940 SANTA TERESA BLVD
Second Line	:	SUITE#4
City	:	SAN JOSE
State	:	CA
Zip	:	95119-1345
Country	:	US
Telephone Number	:	408-972-2811
Fax Number	:	408-972-2836

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. AMER SAFADI
Credential	:	D.M.D
Telephone Number	:	408-972-2811

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	08/22/2020

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