Provider Demographics
NPI:1528498326
Name:SHAHKARAMI, ANOOSHEH
Entity type:Individual
Prefix:DR
First Name:ANOOSHEH
Middle Name:
Last Name:SHAHKARAMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18399 VENTURA BLVD STE 251
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-6401
Mailing Address - Country:US
Mailing Address - Phone:818-345-5286
Mailing Address - Fax:
Practice Address - Street 1:18399 VENTURA BLVD STE 251
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6401
Practice Address - Country:US
Practice Address - Phone:818-345-5286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA516511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice