Shahram Shidmand DDS Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48018 Issued in CA

Legal business name

SHAHRAM SHIDMAND DDS INC

Practice address

1211 N del Mar Ave
Fresno, CA 93728-1958

Phone

(559) 497-8300

Fax

(559) 497-1501

NPI assigned

May 16, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sean Shidmand, DDS

Title

President

Phone

(559) 479-8300

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073720504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 N DEL MAR AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937281958",
            "telephone_number": "559-497-8300",
            "fax_number": "559-497-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 N DEL MAR AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937281958",
            "telephone_number": "559-497-8300",
            "fax_number": "559-497-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHRAM SHIDMAND DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHIDMAND",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-479-8300",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G92364-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randall John Shahbazian, M.D.
• Zaruhi Shahbazyan, DDS
• Ali Shahcheraghi, DMD
• Shahinfar MD Inc
• Farnaz F Shahraki
• Sholeh H Shahrokhi, M.S. R.D.
• Ahmed Shahzad
• Ayesha Shahzad
• Sadiq Karim Shaikh, HIGH SCHOOL GRADUATE
• Reza Shakeri, D.C.

• General Practice Dentistry in Fresno, CA
• Providers in Fresno, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.