Shahrzad Doulatshahi Aarup, DDS

Individual provider Active NPI General Practice Dentistry · Pomona, CA

NPI 1265784367 · NPPES record last updated Dec 20, 2021

Key facts

NPI
1265784367
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
SP290 (CA)
Practice address
309 E 2ND St
Pomona, CA 91766-1854
Phone
(909) 469-8641
Fax
(909) 706-3800
NPI assigned
Oct 12, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SP290CAMDGeneral Practice Dentistry
28450TXMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 28450 TX
General Practice Dentistry 1223G0001X SP290 CA Yes

Addresses

Primary practice location

309 E 2ND St
Pomona, CA 91766-1854

Mailing address

309 E 2ND St
Pomona, CA 91766-1854
Phone (909) 469-8641

Other providers in Pomona, CA

All providers in Pomona, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.