Provider Demographics
NPI:1023769908
Name:SHARIF, AZIN I (DDS)
Entity type:Individual
Prefix:DR
First Name:AZIN
Middle Name:
Last Name:SHARIF
Suffix:I
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CALLE ALBARDA
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-2310
Mailing Address - Country:US
Mailing Address - Phone:949-529-2000
Mailing Address - Fax:
Practice Address - Street 1:10 CALLE ALBARDA
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-2310
Practice Address - Country:US
Practice Address - Phone:949-529-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107246122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA107246Medicaid