Shahrokh Shabahang, DDS,MS,PHD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

35778 Issued in CA

Practice address

17260 Bear Valley Rd Ste 108
Victorville, CA 92395-7778

Phone

(760) 951-4646

Fax

(760) 951-4647

NPI assigned

Mar 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235269812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17260 BEAR VALLEY RD STE 108",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957778",
            "telephone_number": "760-951-4646",
            "fax_number": "760-951-4647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17260 BEAR VALLEY RD STE 108",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957778",
            "telephone_number": "760-951-4646",
            "fax_number": "760-951-4647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABAHANG",
        "first_name": "SHAHROKH",
        "name_prefix": "Mr.",
        "credential": "DDS,MS,PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "35778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC. #",
            "identifier": "35778",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Sessler
• Jayla Severin
• Patricia Sewell
• SG Homecare,Inc. (Stance Health Solutions)
• Omar Shaar, MD
• Adia Naki Shabazz-Regains
• Sarah Shabazz
• Montana M Shaffer, MA
• Bharati Shah, MD
• Nicky Shah, MD

• Endodontics in Victorville, CA
• Providers in Victorville, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.