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Physician Compare National (NPI:1053440156)

HEALTHCARE PROVIDER: SHAHIN JAVID DDS

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1053440156
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 9234358151
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20200324000462
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name JAVID
Individual professional last name
Provider First Name SHAHIN
Individual professional first name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name FOREIGN DENTAL SCHOOLS
Individual professional's medical school
Graduation Year 1990
Individual professional's medical school graduation year
Primary Specialty ORAL SURGERY
Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1 DENTIST
First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties DENTIST
All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information

Line 1 Street Address 27420 TOURNEY RD
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 230A
Group Practice or individual's line 2 address
City VALENCIA
Group Practice or individual's city
State CA
Group Practice or individual's state
Zip Code 913555635
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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