| Shirin Yasrebi, Dds | |
|
2015 E Edgewood Dr Lakeland FL 33803-3601 | |
| (863) 667-9000 | |
| (863) 665-4368 |
| Full Name | Shirin Yasrebi, Dds |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2015 E Edgewood Dr, Lakeland, Florida |
| Authorized Official Name and Position | Shirin Yasrebi (DENTIST) |
| Authorized Official Contact | 8636679000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shirin Yasrebi, Dds 2015 E Edgewood Dr Lakeland FL 33803-3601 Ph: (863) 667-9000 | Shirin Yasrebi, Dds 2015 E Edgewood Dr Lakeland FL 33803-3601 Ph: (863) 667-9000 |
| NPI Number | 1427219773 |
|---|---|
| Provider Enumeration Date | 06/19/2008 |
| Last Update Date | 06/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427219773 | NPI | - | NPPES |
| 073762300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DN12434 (Florida) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | DN5634 (Florida) | Secondary |
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