Provider Demographics
NPI:1740584242
Name:SHARIFI, SARVENAZ (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARVENAZ
Middle Name:
Last Name:SHARIFI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19888 PROSPECT RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-3155
Mailing Address - Country:US
Mailing Address - Phone:408-252-6000
Mailing Address - Fax:
Practice Address - Street 1:19888 PROSPECT RD
Practice Address - Street 2:SUITE B
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-3155
Practice Address - Country:US
Practice Address - Phone:408-252-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA600711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice