Provider Demographics
NPI:1962617233
Name:SHARIFI, BEHNAZ (DMD)
Entity type:Individual
Prefix:DR
First Name:BEHNAZ
Middle Name:
Last Name:SHARIFI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26700 TOWNE CENTRE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-2843
Mailing Address - Country:US
Mailing Address - Phone:949-581-5151
Mailing Address - Fax:949-581-6058
Practice Address - Street 1:26700 TOWNE CENTRE DR STE 130
Practice Address - Street 2:
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2843
Practice Address - Country:US
Practice Address - Phone:949-581-5151
Practice Address - Fax:949-581-6058
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA567501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice