Provider Demographics
NPI:1609123991
Name:SARFARAZ, YASER (DDS)
Entity type:Individual
Prefix:DR
First Name:YASER
Middle Name:
Last Name:SARFARAZ
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 1:14337 GEORGIA AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-2784
Mailing Address - Country:US
Mailing Address - Phone:301-256-8646
Mailing Address - Fax:
Practice Address - Street 1:12114 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5522
Practice Address - Country:US
Practice Address - Phone:301-942-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15104122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist