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General NPI Number Information
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NPI Number | 1396254991
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Entity Type | Organization
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Legal Business Name | NAHIDEH SHOJAEI DDS , PC
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Dates
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Enumeration Date | 09/26/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 475 E ALMOND AVE STE 103
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City | MADERA
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State | CA
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Zip | 93637-5750
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Country | US
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Telephone | 559-662-1010
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Fax | 559-662-0942
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Provider Business Mailing Address
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Address Line | 475 E ALMOND AVE STE 103
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City | MADERA
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State | CA
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Zip | 93637-5750
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Country | US
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Telephone | 559-662-1010
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Fax | 559-662-0942
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NAHIDEH SHOJAEI
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Credential | DDS
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Telephone | 559-662-1010
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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 | 59804
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 59804
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License Number State | CA
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