Provider Demographics
NPI:1336217090
Name:SYED, RAFIA S (BDS)
Entity Type:Individual
Prefix:
First Name:RAFIA
Middle Name:S
Last Name:SYED
Suffix:
Gender:F
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 SCOTT BLVD
Mailing Address - Street 2:SUITE A 2
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-4547
Mailing Address - Country:US
Mailing Address - Phone:408-985-7933
Mailing Address - Fax:408-554-5856
Practice Address - Street 1:1150 SCOTT BLVD
Practice Address - Street 2:SUITE A 2
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-4547
Practice Address - Country:US
Practice Address - Phone:408-985-7933
Practice Address - Fax:408-554-5856
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA370591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice