MEDICARE: DR. ASMITA A DHARIA 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
1	122300000X	Dentist	54247	CA

General Provider Information

NPI Number	:	1619163920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASMITA A DHARIA DDS

Provider Business Mailing Address
First Line	:	1401 RED HAWK CIR
Second Line	:	N-304
City	:	FREMONT
State	:	CA
Zip	:	94538-4747
Country	:	US
Telephone Number	:	510-505-9522
Fax Number	:

Provider Business Practice Location Address
First Line	:	423 N L ST
Second Line	:
City	:	LIVERMORE
State	:	CA
Zip	:	94551-8005
Country	:	US
Telephone Number	:	925-449-7167
Fax Number	:

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

Provider Enumeration Date	:	09/20/2007
Last Update Date	:	09/20/2007

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