Provider Demographics
NPI:1326599101
Name:SHARIFI, MOHAMMAD NAZIF (DMD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:NAZIF
Last Name:SHARIFI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 NW 46TH ST STE 106
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-4622
Mailing Address - Country:US
Mailing Address - Phone:702-954-9777
Mailing Address - Fax:
Practice Address - Street 1:1416 NW 46TH ST STE 106
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4622
Practice Address - Country:US
Practice Address - Phone:206-783-0330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV68371223G0001X
WADE608075911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice