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General NPI Number Information
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NPI Number | 1134533953
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Entity Type | Individual
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Provider Name | DENA SHAHANI O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/19/2014
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Last Update Date | 07/27/2023
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Provider Practice Location Address
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Address Line | 1284 AUTO PARK WAY STE C
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City | ESCONDIDO
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State | CA
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Zip | 92029-2222
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Country | US
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Telephone | 760-745-9065
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Fax |
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Provider Business Mailing Address
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Address Line | 6425 OAKRIDGE RD
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City | SAN DIEGO
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State | CA
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Zip | 92120-2151
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Country | US
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Telephone | 651-808-0247
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 009530
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT-002618
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT.0003895
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | NA2937
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License Number State | MD
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Taxonomy #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 14956
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License Number State | CA
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