Healthcare Provider Details

I. General information

NPI: 1376959411
Provider Name (Legal Business Name): PARHAM SHAHKAR DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2014
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 CENTRE ST
MALDEN MA
02148-5524
US

IV. Provider business mailing address

209 CENTRE ST
MALDEN MA
02148-5524
US

V. Phone/Fax

Practice location:
  • Phone: 781-288-5158
  • Fax:
Mailing address:
  • Phone: 617-721-2443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN1856932
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1856932
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: