MEDICARE: AJAY AND SANAZ DENTAL CORP

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1518820695
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AJAY AND SANAZ DENTAL CORP

Provider Business Mailing Address
First Line	:	831 HARRIS ST STE C
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95503-4501
Country	:	US
Telephone Number	:	707-443-3005
Fax Number	:	707-443-1467

Provider Business Practice Location Address
First Line	:	831 HARRIS ST STE C
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95503-4501
Country	:	US
Telephone Number	:	707-443-3005
Fax Number	:	707-443-1467

Authorized Official
Title or Position	:	DENTIST
Name	:	SANAZ AKBARI
Credential	:	DDS
Telephone Number	:	707-443-3005

Provider Enumeration Date	:	12/05/2025
Last Update Date	:	12/05/2025

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