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General NPI Number Information
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NPI Number | 1548095938
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Entity Type | Individual
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Provider Name | SEAN SHAYAN MOJAVER DDS
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Gender | Male
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Dates
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Enumeration Date | 09/04/2024
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 945 CREST RD
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City | DEL MAR
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State | CA
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Zip | 92014-2617
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Country | US
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Telephone | 858-357-1778
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 463024
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City | ESCONDIDO
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State | CA
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Zip | 92046-3024
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Country | US
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Telephone | 858-357-1778
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DDS110588
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License Number State | CA
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