Provider Demographics
NPI:1265457048
Name:TAJBAKHSH, SHARAREH (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:SHARAREH
Middle Name:
Last Name:TAJBAKHSH
Suffix:
Gender:F
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10383 TORRE AVE
Mailing Address - Street 2:STE.# 1
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-3238
Mailing Address - Country:US
Mailing Address - Phone:408-257-3031
Mailing Address - Fax:408-257-5842
Practice Address - Street 1:10383 TORRE AVE
Practice Address - Street 2:STE.# 1
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-3238
Practice Address - Country:US
Practice Address - Phone:408-257-3031
Practice Address - Fax:408-257-5842
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49007122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist