Healthcare Provider Details

I. General information

NPI: 1023982147
Provider Name (Legal Business Name): VREJ SHAHMORADIAN D.D.S. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44725 10TH ST W STE 260
LANCASTER CA
93534-3049
US

IV. Provider business mailing address

44725 10TH ST W STE 260
LANCASTER CA
93534-3049
US

V. Phone/Fax

Practice location:
  • Phone: 661-942-1474
  • Fax:
Mailing address:
  • Phone: 661-942-1474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. VREJ SHAHMORADIAN
Title or Position: DENTIST
Credential: DDS
Phone: 661-942-1474