Provider Demographics
NPI:1770601403
Name:SCHARF, SCOTT D (DDS)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:SCHARF
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 1:15600 36TH AVE N
Mailing Address - Street 2:SUITE 270
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55446-3369
Mailing Address - Country:US
Mailing Address - Phone:763-557-0911
Mailing Address - Fax:763-557-5157
Practice Address - Street 1:15600 36TH AVE N
Practice Address - Street 2:SUITE 270
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55446-3369
Practice Address - Country:US
Practice Address - Phone:763-557-0911
Practice Address - Fax:763-557-5157
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN100111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN44102222900Medicare ID - Type UnspecifiedMEDICAL ASSISTANCE