Healthcare Provider Details

I. General information

NPI: 1902724685
Provider Name (Legal Business Name): SHAYAN LIAGHAT DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

4875 SUMMIT RIDGE DR
RENO NV
89523-7936
US

IV. Provider business mailing address

8690 HICKORY LEAF PL
ORANGEVALE CA
95662-3444
US

V. Phone/Fax

Practice location:
  • Phone: 775-200-1660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDDS113253
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: