Provider Demographics
NPI:1174631840
Name:MAJID SHAROLLI, D.D.S., P.A.
Entity Type:Organization
Organization Name:MAJID SHAROLLI, D.D.S., P.A.
Other - Org Name:WICHITA FALLS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAJID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAROLLI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:940-585-7409
Mailing Address - Street 1:2100 BROOK AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-5626
Mailing Address - Country:US
Mailing Address - Phone:940-322-5297
Mailing Address - Fax:940-322-5298
Practice Address - Street 1:2100 BROOK AVE
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-5626
Practice Address - Country:US
Practice Address - Phone:940-322-5297
Practice Address - Fax:940-322-5298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX198101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty