MEDICARE: STEPHEN SAROFF, D.D.S. P.C.

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	1223P0300X	Periodontics	0401004190	VA

General Provider Information

NPI Number	:	1841339553
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN SAROFF, D.D.S. P.C.

Provider Business Mailing Address
First Line	:	2801 MCRAE RD
Second Line	:	C-1
City	:	RICHMOND
State	:	VA
Zip	:	23235-3056
Country	:	US
Telephone Number	:	804-272-9079
Fax Number	:	804-272-9107

Provider Business Practice Location Address
First Line	:	2801 MCRAE RD
Second Line	:	C-1
City	:	RICHMOND
State	:	VA
Zip	:	23235-3056
Country	:	US
Telephone Number	:	804-272-9079
Fax Number	:	804-272-9107

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEPHEN ANDREW SAROFF
Credential	:	D.D.S.
Telephone Number	:	804-272-9079

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	08/22/2020

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