MEDICARE: HAMIDEH SHAMSAI 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	30-021185	OH
2	122300000X	Dentist	48182	CA

General Provider Information

NPI Number	:	1801001821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAMIDEH SHAMSAI DDS

Provider Business Mailing Address
First Line	:	4578 PINE TREE CT
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43082-8798
Country	:	US
Telephone Number	:	614-891-5311
Fax Number	:

Provider Business Practice Location Address
First Line	:	1271 MORSE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-6320
Country	:	US
Telephone Number	:	614-261-1488
Fax Number	:	614-261-1490

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

Provider Enumeration Date	:	05/12/2007
Last Update Date	:	07/08/2007

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Directions to “ HAMIDEH SHAMSAI DDS” Practice Location

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