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General NPI Number Information
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NPI Number | 1851492029
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Entity Type | Individual
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Provider Name | SHAHNAZ BONYANPOOR D.D.S
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Gender | Female
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 08/23/2007
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Provider Practice Location Address
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Address Line | 62 CORPORATE PARK SUITE 135
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City | IRVINE
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State | CA
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Zip | 92606-3122
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Country | US
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Telephone | 949-252-9950
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Fax | 949-252-9959
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Provider Business Mailing Address
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Address Line | 62 CORPORATE PARK SUITE 135
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City | IRVINE
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State | CA
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Zip | 92606-3122
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Country | US
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Telephone | 949-252-9950
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Fax | 949-252-9959
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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 | 44292
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License Number State | CA
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