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General NPI Number Information
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NPI Number | 1487967154
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Entity Type | Individual
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Provider Name | BEHZAD SHELECHI DDS
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Gender | Male
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Dates
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Enumeration Date | 07/22/2010
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Last Update Date | 07/22/2010
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Provider Practice Location Address
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Address Line | 34460 MONTEREY AVE
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City | PALM DESERT
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State | CA
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Zip | 92211-6008
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Country | US
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Telephone | 760-610-0358
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Fax |
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Provider Business Mailing Address
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Address Line | 23775 DOLPHIN CV
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-1642
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Country | US
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Telephone | 949-395-3586
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 59304
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License Number State | CA
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