Individual provider Active NPI

Shohreh Shahram, DDS

  • Dentist
  • Vienna, VA
National Provider Identifier
1720314099
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401412160 Issued in VA
Practice address
8605 Westwood Center Dr
Suite 210
Vienna, VA 22182-2240
Phone
(703) 442-0770
Fax
(703) 442-0771
NPI assigned
Oct 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14222 MD
Dentist 122300000X 0401412160 VA Primary

Addresses

Primary practice location

8605 Westwood Center Dr
Suite 210
Vienna, VA 22182-2240

Mailing address

8605 Westwood Center Dr
Suite 210
Vienna, VA 22182-2240
Phone (703) 442-0770

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14222MDMDDentist
0401412160VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
A. Sanati D.D.S & S. Shahram D.D.S PC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1720314099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8605 WESTWOOD CENTER DR",
            "address_2": "SUITE 210",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822240",
            "telephone_number": "703-442-0770",
            "fax_number": "703-442-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8605 WESTWOOD CENTER DR",
            "address_2": "SUITE 210",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822240",
            "telephone_number": "703-442-0770",
            "fax_number": "703-442-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHRAM",
        "first_name": "SHOHREH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-21",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "14222",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401412160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.