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General NPI Number Information
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NPI Number | 1366396921
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Entity Type | Organization
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Legal Business Name | SHAKIBA DENTAL GROUP PC
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Dates
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Enumeration Date | 02/23/2026
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Last Update Date | 02/23/2026
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Provider Practice Location Address
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Address Line | 431 W 13TH AVE STE BC
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City | ESCONDIDO
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State | CA
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Zip | 92025-5782
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Country | US
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Telephone | 760-743-9003
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Fax |
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Provider Business Mailing Address
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Address Line | 11502 CREEK RD
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City | POWAY
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State | CA
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Zip | 92064-6113
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Country | US
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Telephone |
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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. PAYMAUN SHAKIBA
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Credential | DMD
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Telephone | 858-945-7610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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