Basic Information
| Provider Information | |||||||||
| NPI: | 1689869257 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SARVI | ||||||||
| FirstName: | SAUNAZ | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6363 CHRISTIE AVE | ||||||||
| Address2: | APT#1512 | ||||||||
| City: | EMERYVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946081914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8004174444 | ||||||||
| FaxNumber: | 7145713560 | ||||||||
| Practice Location | |||||||||
| Address1: | 115 BERKELEY SQARE | ||||||||
| Address2: | |||||||||
| City: | BERKELEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5105408400 | ||||||||
| FaxNumber: | 5105400609 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2007 | ||||||||
| LastUpdateDate: | 09/07/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 55610 | CA | Y | Dental Providers | Dentist |
ID Information
| ID | Type | State | Issuer | Description | D55610 | 05 | CA | MEDICAID |