Shahram Taheri, DDS, MS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

43736 Issued in CA

Practice address

704 Blossom Hill Rd
Suite 104
San Jose, CA 95123-5403

Phone

(408) 226-0323

Fax

(408) 226-4418

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Shawn -------- Taheri Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Shawn Taheri DDS, Ms Inc

  • Pediatric Dentistry
  • San Jose, CA
  • NPI 1780954057
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972522209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 BLOSSOM HILL RD",
            "address_2": "SUITE 104",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951235403",
            "telephone_number": "408-226-0323",
            "fax_number": "408-226-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 BLOSSOM HILL RD",
            "address_2": "SUITE 104",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951235403",
            "telephone_number": "408-226-0323",
            "fax_number": "408-226-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHERI",
        "first_name": "SHAHRAM",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "43736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWN",
            "last_name": "TAHERI",
            "middle_name": "--------",
            "prefix": "DR.",
            "credential": "DDS, MS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Sabina Tah May, LCSW
• Anoushka Tahaei, MFTI
• Sogand Tahamtan
• Natalie Tahara, OTR/L
• Mitra N/a Taheri
• Siavash Taheri, RN
• Victoria Shireen Tahmassebi, PA-C
• Phoebe Tai
• Sydney Louise Tai
• Carole Ann Tait-Starnes, M.A.

• Pediatric Dentistry in San Jose, CA
• Providers in San Jose, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.