MEDICARE: DR. SHEILA MAHOOTI DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	50314	CA

General Provider Information

NPI Number	:	1144546524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHEILA MAHOOTI DDS

Provider Business Mailing Address
First Line	:	5363 BALBOA BLVD STE 325
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91316-2807
Country	:	US
Telephone Number	:	818-600-1884
Fax Number	:	818-646-0636

Provider Business Practice Location Address
First Line	:	5363 BALBOA BLVD STE 325
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91316-2807
Country	:	US
Telephone Number	:	818-600-1884
Fax Number	:	818-646-0636

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2010
Last Update Date	:	02/11/2026

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