MEDICARE: SHEERIN H YUSUF D.M.D.

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	DS037859	PA
2	1223E0200X	Endodontics	DN014353	GA

General Provider Information

NPI Number	:	1255569026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEERIN H YUSUF D.M.D.

Provider Business Mailing Address
First Line	:	1630 PLEASANT HILL RD
Second Line	:	200
City	:	DULUTH
State	:	GA
Zip	:	30096-5899
Country	:	US
Telephone Number	:	248-854-3386
Fax Number	:

Provider Business Practice Location Address
First Line	:	1630 PLEASANT HILL RD
Second Line	:	200
City	:	DULUTH
State	:	GA
Zip	:	30096-5899
Country	:	US
Telephone Number	:	248-854-3386
Fax Number	:

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

Provider Enumeration Date	:	06/30/2009
Last Update Date	:	09/21/2018

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