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General NPI Number Information
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NPI Number | 1023731924
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Entity Type | Organization
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Legal Business Name | SHAMSIAN HARIRI DENTAL CORP
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 8982 WASHINGTON BLVD
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City | PICO RIVERA
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State | CA
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Zip | 90660-3765
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Country | US
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Telephone | 562-222-1551
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Fax |
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Provider Business Mailing Address
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Address Line | 8982 WASHINGTON BLVD
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City | PICO RIVERA
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State | CA
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Zip | 90660-3765
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Country | US
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Telephone | 562-222-1551
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHAHRIYAR SHAMSIAN
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Credential | DDS
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Telephone | 818-674-8487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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