Shiva Mohazab, D.D.S

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DDS101426 Issued in CA

Practice address

24634 Madison Ave Ste E
Murrieta, CA 92562

Phone

(951) 600-1062

NPI assigned

Oct 1, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1124421334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16011 BUTTERFIELD RANCH RD UNIT 235",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917097456",
            "telephone_number": "310-597-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24634 MADISON AVE STE E",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "92562",
            "telephone_number": "951-600-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAZAB",
        "first_name": "SHIVA",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-01",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "DDS101426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mohammad Ali Zareh DDS Inc
• Alan Mohr
• Miriam Mojica Santos
• Pamela Enjema Mokoko, FAMILY NURSE PRACTIT
• Mario Molina-Robles
• Carly Lauren Mollicone, PMHNP-BC

• Pediatric Dentistry in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; 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.