Healthcare Provider Details

I. General information

NPI: 1710500954
Provider Name (Legal Business Name): SHAHIN PAHLEVANI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2020
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4135 BLACKHAWK PLAZA CIR STE 200
DANVILLE CA
94506-4655
US

IV. Provider business mailing address

4135 BLACKHAWK PLAZA CIR STE 200
DANVILLE CA
94506-4655
US

V. Phone/Fax

Practice location:
  • Phone: 925-217-0000
  • Fax:
Mailing address:
  • Phone: 925-217-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number30.026591
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number107752
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: