MEDICARE: SHIVA SALEHI DDS A DENTAL CORP

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

General Provider Information

NPI Number	:	1487445300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHIVA SALEHI DDS A DENTAL CORP

Provider Business Mailing Address
First Line	:	540 BOGUE RD STE 6
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95991-9245
Country	:	US
Telephone Number	:	530-822-9090
Fax Number	:	530-822-9096

Provider Business Practice Location Address
First Line	:	540 BOGUE RD STE 6
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95991-9245
Country	:	US
Telephone Number	:	530-822-9090
Fax Number	:	530-822-9096

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	ARACELLA YANG
Credential	:
Telephone Number	:	916-229-8283

Provider Enumeration Date	:	05/13/2025
Last Update Date	:	05/13/2025

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