Provider Demographics
NPI:1215129408
Name:DR SAID SHAARI
Entity type:Organization
Organization Name:DR SAID SHAARI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-789-4568
Mailing Address - Street 1:406 SUNRISE AVENUE
Mailing Address - Street 2:SUITE 270
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661
Mailing Address - Country:US
Mailing Address - Phone:916-789-4568
Mailing Address - Fax:916-789-7344
Practice Address - Street 1:406 SUNRISE AVENUE
Practice Address - Street 2:SUITE 270
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661
Practice Address - Country:US
Practice Address - Phone:916-789-4568
Practice Address - Fax:916-789-7344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
122300000X
CA39080302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
No122300000XDental ProvidersDentistGroup - Single Specialty