Shiva Mohtasham DDS, Inc

Primary specialty

DentistTaxonomy code 122300000X

License

51976 Issued in CA

Legal business name

SHIVA MOHTASHAM DDS, INC

Doing business as

Shine On Dental Group

Practice address

1501 Bollinger Canyon Rd Ste F
San Ramon, CA 94583-1758

Phone

(510) 857-7544

Fax

(925) 208-1852

NPI assigned

Oct 30, 2015

Last updated

Oct 30, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shiva Mohtasham, DDS

Title

Owner

Phone

(510) 857-7544

Specialties & licenses 1

Addresses

Other names 1

• Shine On Dental Group Doing business as

Locations

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446163200000",
    "number": "1619349511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2887 FIELDVIEW TER",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831900",
            "telephone_number": "510-857-7544",
            "fax_number": "925-208-1852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 BOLLINGER CANYON RD STE F",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831758",
            "telephone_number": "510-857-7544",
            "fax_number": "925-208-1852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIVA MOHTASHAM DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-30",
        "last_updated": "2015-10-30",
        "status": "A",
        "authorized_official_last_name": "MOHTASHAM",
        "authorized_official_first_name": "SHIVA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-857-7544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "51976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shine On Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tamara Shih, PT, MPT
• Soyeon Shim
• Benjamin Ryan Shimel, DDS
• Rachel Jane Shimer-Lal, MOT, OTR/L
• Shining Pathways Counseling Group Inc
• Yshay Shlesinger, M.D.
• Sarbjeet Kaur Shokar, RN
• Shoker Dental Care Inc.
• Shilpa Shrestha, FNP-C
• Vicky Siauw

• Dentist in San Ramon, CA
• Providers in San Ramon, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; 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.