MEDICARE: DR. BABAK SHEMIRANI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	47561	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609913813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BABAK SHEMIRANI

Provider Business Mailing Address
First Line	:	3705 BEACON AVE STE 100
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94538-1467
Country	:	US
Telephone Number	:	510-793-9025
Fax Number	:	510-793-7704

Provider Business Practice Location Address
First Line	:	3705 BEACON AVE STE 100
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94538-1467
Country	:	US
Telephone Number	:	510-793-9025
Fax Number	:	510-793-7704

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	04/09/2020

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Directions to “ DR. BABAK SHEMIRANI ” Practice Location

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