Provider Demographics
NPI:1376697524
Name:YAZDI, SHERVIN K IX (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHERVIN
Middle Name:K
Last Name:YAZDI
Suffix:IX
Gender:M
Credentials:DDS
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Mailing Address - Street 1:20700 LAKE CHABOT RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5303
Mailing Address - Country:US
Mailing Address - Phone:510-538-2098
Mailing Address - Fax:510-538-1958
Practice Address - Street 1:20700 LAKE CHABOT RD
Practice Address - Street 2:SUITE 205
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5303
Practice Address - Country:US
Practice Address - Phone:510-538-2098
Practice Address - Fax:510-538-1958
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CA418831223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry