Shervin Akhamzadeh, D.D.S.
Individual provider Active NPI Dentist · Sylmar, CA
NPI 1992828347 · NPPES record last updated Jan 12, 2015
Key facts
- NPI
- 1992828347
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 58030 (CA)
- Practice address
- 14114 Polk St
Sylmar, CA 91342-2918 - Phone
- (818) 364-9444
- NPI assigned
- Apr 9, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Simon Masood Imanuel DMD,Inc. | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 58030 | CA | Yes |
Addresses
Primary practice location
14114 Polk St
Sylmar, CA 91342-2918
Mailing address
18221 Clark St
Tarzana, CA 91356-3601
Phone (443) 802-9634
Other providers in Sylmar, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.