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NPI Code Detail

MEDICARE: LANA SHMURAKOV DDS

MEDICARE:   LANA  SHMURAKOV  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
1122300000XDentist56335CA

General Provider Information

NPI Number : 1326234410
Entity Type Code : Individual
Provider Name (Legal Business Name) : LANA SHMURAKOV DDS
Provider Business Mailing Address
First Line : 13622 ADDISON ST
Second Line :
City : SHERMAN OAKS
State : CA
Zip : 91423-1412
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3535 ROSS AVE STE 304
Second Line :
City : SAN JOSE
State : CA
Zip : 95124-3038
Country : US
Telephone Number : 408-265-4064
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2007
Last Update Date : 09/21/2007

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Directions to “ LANA SHMURAKOV DDS” Practice Location

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