Organization Active NPI

Shir Dental Corp

  • Dentist
  • San Diego, CA
National Provider Identifier
1740913490
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SHIR DENTAL CORP
Practice address
6545 Balboa Ave Ste a
San Diego, CA 92111-3156
Phone
(858) 292-7655
NPI assigned
Jul 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Authorized official

Name
Dr. Shahrzad Prater, DMD
Title
Owner
Phone
(619) 770-8742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

6545 Balboa Ave Ste a
San Diego, CA 92111-3156

Mailing address

6545 Balboa Ave Ste a
San Diego, CA 92111-3156
Phone (858) 292-7655

Other identifiers 1

IdentifierTypeStateIssuer
1962864884MedicaidCA

Other names 1

  • Del Rey Dental Doing business as

National Provider Directory

National Provider Directory

Locations

6545 Balboa Ave
Ste A
San Diego, CA 92111
Phone (858) 292-7655

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769990400000",
    "number": "1740913490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 BALBOA AVE STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113156",
            "telephone_number": "858-292-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 BALBOA AVE STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113156",
            "telephone_number": "858-292-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIR DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-08",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A",
        "authorized_official_last_name": "PRATER",
        "authorized_official_first_name": "SHAHRZAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-770-8742",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962864884",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Del Rey Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; 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.