Healthcare Provider Details

I. General information

NPI: 1942477930
Provider Name (Legal Business Name): TAMIR SHAMS DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2008
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8383 WILSHIRE BLVD STE 358
BEVERLY HILLS CA
90211-2436
US

IV. Provider business mailing address

8383 WILSHIRE BLVD STE 358
BEVERLY HILLS CA
90211-2436
US

V. Phone/Fax

Practice location:
  • Phone: 310-663-4303
  • Fax:
Mailing address:
  • Phone: 310-663-4303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number26280
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number56712
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number56712
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: