Individual
FARIBA SHARIFAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
639 MOUNT PROSPECT AVE, NEWARK, NJ 07104-3109
(973) 481-3900
(973) 481-2999
Mailing address
639 MOUNT PROSPECT AVE, NEWARK, NJ 07104-3109
(973) 481-3900
(973) 481-2999
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02029500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0110221
—
NJ
05
—
7943601
—
NJ
Enumeration date
12/20/2006
Last updated
09/14/2012
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