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NPI Code Detail

MEDICARE: SAJJAD SHAHMORADI

MEDICARE: SAJJAD SHAHMORADI
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
1122300000XDentist18568MD

General Provider Information

NPI Number : 1841070745
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAJJAD SHAHMORADI
Provider Business Mailing Address
First Line : 1128 PECANLAND RD STE 1
Second Line :
City : MONROE
State : LA
Zip : 71203-7019
Country : US
Telephone Number : 318-459-9739
Fax Number :
Provider Business Practice Location Address
First Line : 1460 RITCHIE HWY STE 203
Second Line :
City : ARNOLD
State : MD
Zip : 21012-2741
Country : US
Telephone Number : 443-375-5035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2023
Last Update Date : 03/11/2026

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Directions to “ SAJJAD SHAHMORADI ” Practice Location

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