Babak Shoushtari, D.M.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

47562 Issued in CA

Practice address

4150 Regents Park Row
Suite 330
La Jolla, CA 92037-9124

Phone

(858) 546-9299

Fax

(858) 546-9399

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469577600000",
    "number": "1841301728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 REGENTS PARK ROW",
            "address_2": "SUITE 330",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920379124",
            "telephone_number": "858-546-9299",
            "fax_number": "858-546-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 REGENTS PARK ROW",
            "address_2": "SUITE 330",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920379124",
            "telephone_number": "858-546-9299",
            "fax_number": "858-546-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOUSHTARI",
        "first_name": "BABAK",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "47562",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "DDS47562",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hoda Shirazian
• Stephen C Shoemaker, M.D.
• Edward C Shontz, MD
• Brian J. Shore, M.D.
• Lindsay Sarah Short, N.P.
• Neni Diah Shriver, DDS
• Sean Christopher Shughrou, PA-C
• George M Shumaik, MD
• Robert Alan Shumway, M.D.
• Natalie Shunnarah, RN

• Endodontics in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.