MEDICARE: SALLY AKRAWE D.D.S.

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	106867	CA

General Provider Information

NPI Number	:	1639330178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALLY AKRAWE D.D.S.

Provider Business Mailing Address
First Line	:	4200 BROOKE CT UNIT 704
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122-5289
Country	:	US
Telephone Number	:	248-346-7696
Fax Number	:

Provider Business Practice Location Address
First Line	:	11943 EL CAMINO REAL STE 200
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92130-2597
Country	:	US
Telephone Number	:	858-336-8478
Fax Number	:

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

Provider Enumeration Date	:	06/18/2008
Last Update Date	:	06/23/2026

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