Shamir Mavi

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

100113 Issued in CA

Practice address

703 N Golden State Blvd
Turlock, CA 95380-3953

Phone

(209) 216-4198

NPI assigned

Mar 29, 2016

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1740642768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 N GOLDEN STATE BLVD",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953803953",
            "telephone_number": "209-216-4198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N GOLDEN STATE BLVD",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953803953",
            "telephone_number": "209-216-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVI",
        "first_name": "SHAMIR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "100113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Catherine Wolf
• Maryam Esho, M.D., a Professional Corporation
• Raul Mata
• Edrees Mateen, M.D.
• Neal James Mathew, PA-C
• Sergio Alonzo Mazon, M.D.
• Daniel McCauley, MD
• Andrew Herrick McClure, MFT
• Yessenia McCombs Pena
• Haley McCormick

• General Practice Dentistry in Turlock, CA
• Providers in Turlock, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.