Provider Demographics
NPI:1225150659
Name:NIAZI SHARAKI, ARASH (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARASH
Middle Name:
Last Name:NIAZI SHARAKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5122 OLYMPIC DRIVE NW
Mailing Address - Street 2:#B 101
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1305
Mailing Address - Country:US
Mailing Address - Phone:253-851-5544
Mailing Address - Fax:
Practice Address - Street 1:5122 OLYMPIC DR NW
Practice Address - Street 2:B 101
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1767
Practice Address - Country:US
Practice Address - Phone:253-851-5544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-05
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00009574122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5049010Medicaid