Shahryar Sefidpour, DDS MSD MSME

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

47661 Issued in CA

Practice address

4150 Douglas Blvd Ste B
Granite Bay, CA 95746-5908

Phone

(916) 774-6986

Fax

(916) 774-6533

NPI assigned

Oct 19, 2016

Last updated

Oct 19, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shahryar Sefidpour,DDS MSD Inc

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Granite Bay, CA
  • NPI 1518093111
  Authorized official Same address or phone

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1649721135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 DOUGLAS BLVD STE B",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957465908",
            "telephone_number": "916-774-6986",
            "fax_number": "916-774-6533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 DOUGLAS BLVD STE B",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957465908",
            "telephone_number": "916-774-6986",
            "fax_number": "916-774-6533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEFIDPOUR",
        "first_name": "SHAHRYAR",
        "name_prefix": "Dr.",
        "credential": "DDS MSD MSME",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-19",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "47661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adriana Sanchez-Boado
• Manveer Sandhu
• Manjinder Singh Saroya, FNP
• Hisaneeah Scalice
• Robin Schermer
• Inderpreet Singh Sekhon, MD
• Simran Sekhon, M.B.B.S
• Sanford Selcon
• Shannon Rosemary Selvaratnam
• Hennessy Seumalu

• Orthodontics and Dentofacial Orthopedics Dentistry in Granite Bay, CA
• Providers in Granite Bay, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.