Individual provider Active NPI

Syed Ali Shareef, DDS

  • Dentist
  • Tucson, AZ
National Provider Identifier
1467029983
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D011117 Issued in AZ
Practice address
9725 N Thornydale Rd Ste 173
Tucson, AZ 85742-5027
Phone
(520) 200-0177
NPI assigned
Jun 4, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X AZ
Dentist 122300000X D011117 AZ Primary

Addresses

Primary practice location

9725 N Thornydale Rd Ste 173
Tucson, AZ 85742-5027

Mailing address

1139 E Pecan Orchard Loop
Sahuarita, AZ 85629-6726
Phone (520) 838-4551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210920000375 CA Order and Referring Only - DentistPractitioner - Dentist 9739586793

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D011117AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Tortolita Dental Group and Orthodontics, LLP Dentist PastSince Jun 6, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1467029983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1139 E PECAN ORCHARD LOOP",
            "city": "SAHUARITA",
            "state": "AZ",
            "postal_code": "856296726",
            "telephone_number": "520-838-4551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9725 N THORNYDALE RD STE 173",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857425027",
            "telephone_number": "520-200-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAREEF",
        "first_name": "SYED",
        "middle_name": "ALI",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D011117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.