Reza J Shirazi, DDS
Individual provider Active NPI Dentist · Indio, CA
NPI 1710049598 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1710049598
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 54475 (CA)
- Practice address
- 81735 Highway 111, Suite a
Indio, CA 92201 - Phone
- (760) 391-4474
- NPI assigned
- Dec 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reza Shirazi DDS Inc | Current | Accepting new patients | |
| Shirazi Dental One a Professional Corporation | Dentist | Current | Accepting new patients |
| Elixir Solutions, LLC | Dentist | Current | Accepting new patients |
| Presi PA PC | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 54475 | CA | Yes |
Addresses
Primary practice location
81735 Highway 111, Suite a
Indio, CA 92201
Mailing address
2849 Muir Trail Dr
Fullerton, CA 92833-5517
Phone (310) 694-6156
Other providers in Indio, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.