Provider Demographics
NPI:1972680981
Name:SHARIFI, SHOHREH (DDS)
Entity Type:Individual
Prefix:
First Name:SHOHREH
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 1:6300 WEST LOOP S STE 650
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2997
Mailing Address - Country:US
Mailing Address - Phone:713-663-7960
Mailing Address - Fax:
Practice Address - Street 1:6301 ABRAMS RD STE 125
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-7858
Practice Address - Country:US
Practice Address - Phone:214-348-6033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX222011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice