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General NPI Number Information
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NPI Number | 1639379142
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Entity Type | Individual
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Provider Name | JOSSEIN SHAHANGIAN DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 04/05/2020
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Provider Practice Location Address
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Address Line | 9840 HIBERT ST STE B4
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City | SAN DIEGO
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State | CA
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Zip | 92131-1071
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Country | US
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Telephone | 858-335-1165
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Fax |
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Provider Business Mailing Address
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Address Line | 9840 HIBERT ST SUITE B-4
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City | SAN DIEGO
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State | CA
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Zip | 92131-1071
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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 |
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 59342
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 8551
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 150635
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License Number State | NC
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