MEDICARE: ARMON SHOKOHI D.D.S.

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	1223G0001X	General Practice Dentistry	D6461	AZ
2	1223G0001X	General Practice Dentistry	31516	TX
3	1223G0001X	General Practice Dentistry	59279	CA

General Provider Information

NPI Number	:	1205865375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARMON SHOKOHI D.D.S.

Provider Business Mailing Address
First Line	:	1835 XIMENO AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-2850
Country	:	US
Telephone Number	:	949-307-5527
Fax Number	:

Provider Business Practice Location Address
First Line	:	1835 XIMENO AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-2850
Country	:	US
Telephone Number	:	562-453-1111
Fax Number	:

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

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	01/19/2021

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