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General NPI Number Information
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NPI Number | 1528713534
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Entity Type | Organization
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Legal Business Name | NIMA MASHHOON, DMD, MS INC
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Dates
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Enumeration Date | 02/17/2022
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Last Update Date | 03/10/2022
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Provider Practice Location Address
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Address Line | 2151 S COLLEGE DR STE 103
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City | SANTA MARIA
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State | CA
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Zip | 93455-1304
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Country | US
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Telephone | 805-934-4000
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Fax | 805-803-1999
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Provider Business Mailing Address
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Address Line | 2151 S COLLEGE DR STE 103
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City | SANTA MARIA
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State | CA
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Zip | 93455-1304
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Country | US
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Telephone | 805-934-4000
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Fax | 805-803-1999
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Authorized Official
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Title or Position | DENTIST
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Name | DR. NIMA MASHHOON
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Credential | DMD
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Telephone | 805-934-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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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 | 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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