MEDICARE: ALEX R SHARIFIAN DDS, WARD PARKWAY DENTISTRY, PC

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	:	1548993793
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEX R SHARIFIAN DDS, WARD PARKWAY DENTISTRY, PC

Provider Business Mailing Address
First Line	:	PO BOX 920050
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75392-0050
Country	:	US
Telephone Number	:
Fax Number	:	816-641-2973

Provider Business Practice Location Address
First Line	:	8600 WARD PKWY STE 2130
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64114-2607
Country	:	US
Telephone Number	:	816-631-1791
Fax Number	:	816-641-2973

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALEX R. SHARIFIAN
Credential	:	DDS
Telephone Number	:	816-631-1791

Provider Enumeration Date	:	07/06/2022
Last Update Date	:	07/06/2022

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