Provider Demographics
NPI:1295798916
Name:SHARIFI, NAZANIN (DDS)
Entity type:Individual
Prefix:DR
First Name:NAZANIN
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:PO BOX 8041
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91372-8041
Mailing Address - Country:US
Mailing Address - Phone:818-887-4668
Mailing Address - Fax:
Practice Address - Street 1:22030 SHERMAN WAY
Practice Address - Street 2:SUITE 105
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1855
Practice Address - Country:US
Practice Address - Phone:818-887-4668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA455241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice