Active NPI
Farnaz F Shahraki
- Pediatric Dentistry
- Fresno, CA
National Provider Identifier
1366945115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 110392
- Practice address
- 4220 W Figarden Dr Ste 101
Fresno, CA 93722-6071 - Phone
- (917) 789-3029
- NPI assigned
- Mar 16, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 110392 | CA | Primary |
Addresses
Primary practice location
4220 W Figarden Dr Ste 101
Fresno, CA 93722-6071
Mailing address
1474 E Via Giglio Dr
Fresno, CA 93730-8876
Phone (917) 789-3029
Other practice location 1
111 E 210th St
Bronx, NY 10467-2401
Phone (917) 789-3029
Other practice location 2
4220 W Figarden Dr Ste 101
Fresno, CA 93722-6071
Phone (917) 789-3029
Other practice location 3
997 E Champlain Dr Ste 120
Fresno, CA 93720-0749
Phone (917) 789-3029
Other practice location 4
997 E Champlain Dr Ste 120
Fresno, CA 93720-0749
Phone (917) 789-3029
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- fshahraki92413@valleychildrens-prd.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723420800000",
"number": "1366945115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1474 E VIA GIGLIO DR",
"city": "FRESNO",
"state": "CA",
"postal_code": "937308876",
"telephone_number": "917-789-3029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4220 W FIGARDEN DR STE 101",
"city": "FRESNO",
"state": "CA",
"postal_code": "937226071",
"telephone_number": "917-789-3029"
}
],
"practiceLocations": [
{
"address_1": "111 E 210th St",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104672401",
"country_code": "US",
"telephone_number": "917-789-3029",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4220 W Figarden Dr Ste 101",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937226071",
"country_code": "US",
"telephone_number": "917-789-3029",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "997 E Champlain Dr Ste 120",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937200749",
"country_code": "US",
"telephone_number": "917-789-3029",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "997 E Champlain Dr Ste 120",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937200749",
"country_code": "US",
"telephone_number": "917-789-3029",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHAHRAKI",
"first_name": "FARNAZ",
"middle_name": "F",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-16",
"last_updated": "2024-08-12",
"certification_date": "2024-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "110392",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.