Healthcare Provider Details

I. General information

NPI: 1871613448
Provider Name (Legal Business Name): MOJGAN SHOKRI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3808 W RIVERSIDE DR STE 501
BURBANK CA
91505-4396
US

IV. Provider business mailing address

22405 PINEWOOD CT
CALABASAS CA
91302-5895
US

V. Phone/Fax

Practice location:
  • Phone: 818-779-0299
  • Fax:
Mailing address:
  • Phone: 818-687-6707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number42420
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: