Provider Demographics
NPI:1215298757
Name:CHERAG DINSHAW SARKARI DDS A DENTAL CORPORATION
Entity type:Organization
Organization Name:CHERAG DINSHAW SARKARI DDS A DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHERAG
Authorized Official - Middle Name:D
Authorized Official - Last Name:SARKARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-563-6011
Mailing Address - Street 1:8890 CAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-3200
Mailing Address - Country:US
Mailing Address - Phone:916-922-5000
Mailing Address - Fax:916-646-9000
Practice Address - Street 1:7903 ATLANTIC AVE
Practice Address - Street 2:SUITE G
Practice Address - City:CUDAHY
Practice Address - State:CA
Practice Address - Zip Code:90201-5926
Practice Address - Country:US
Practice Address - Phone:323-773-2200
Practice Address - Fax:323-773-2690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-31
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA509831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG88497-04Medicaid