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NPI Code Detail

MEDICARE: AXIOM DENTISTRY AND ASSOCIATES PC

MEDICARE: AXIOM DENTISTRY AND ASSOCIATES 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
1261QD0000XDental Clinic/Center26556TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11902191703OTHERTXNPI

General Provider Information

NPI Number : 1699142257
Entity Type Code : Organization
Provider Name (Legal Business Name) : AXIOM DENTISTRY AND ASSOCIATES PC
Provider Business Mailing Address
First Line : 1605 N GARLAND AVE STE A
Second Line :
City : GARLAND
State : TX
Zip : 75040-9418
Country : US
Telephone Number : 972-272-7444
Fax Number :
Provider Business Practice Location Address
First Line : 1605 N GARLAND AVE STE A
Second Line :
City : GARLAND
State : TX
Zip : 75040-9418
Country : US
Telephone Number : 972-272-7444
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. SEYED M SHARIATI
Credential : DDS
Telephone Number : 469-767-5105
Provider Enumeration Date : 08/29/2015
Last Update Date : 08/29/2015

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Directions to “AXIOM DENTISTRY AND ASSOCIATES PC ” Practice Location

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