Provider Demographics
NPI:1467029983
Name:SHAREEF, SYED ALI (DDS)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:ALI
Last Name:SHAREEF
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 1:1139 E PECAN ORCHARD LOOP
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-6726
Mailing Address - Country:US
Mailing Address - Phone:520-838-4551
Mailing Address - Fax:
Practice Address - Street 1:9725 N THORNYDALE RD STE 173
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-5027
Practice Address - Country:US
Practice Address - Phone:520-200-0177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-04
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ261QS1000X
AZD011117122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health