Basic Information
Provider Information
NPI: 1245214394
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHARF
FirstName: HARRY
MiddleName: RICHARD
NamePrefix: DR.
NameSuffix:  
Credential: DENTIST
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 401 HOLLY HILLS AVE
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 631112410
CountryCode: US
TelephoneNumber: 3144811615
FaxNumber: 3143531310
Practice Location
Address1: 4352 MANCHESTER AVE
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 631102138
CountryCode: US
TelephoneNumber: 3145315444
FaxNumber: 3145310063
Other Information
ProviderEnumerationDate: 12/02/2005
LastUpdateDate: 01/20/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/20/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X2000173756MOY Dental ProvidersDentist 

ID Information
IDTypeStateIssuerDescription
40582380805MO MEDICAID


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