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General NPI Number Information
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NPI Number | 1649138660
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Entity Type | Organization
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Legal Business Name | SHIFTEH IRANMANESH DMD INC
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Dates
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Enumeration Date | 01/10/2026
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Last Update Date | 01/10/2026
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Provider Practice Location Address
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Address Line | 1650 LAUREL ST STE A
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City | SAN CARLOS
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State | CA
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Zip | 94070-5237
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Country | US
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Telephone | 650-593-0444
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 LAUREL ST STE A
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City | SAN CARLOS
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State | CA
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Zip | 94070-5237
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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 | PRESIDENT
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Name | SHIFTEH IRANMANESH
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Credential | DMD
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Telephone | 650-380-3363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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