Provider Demographics
NPI:1063680916
Name:RASHIDI, SHAHIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHAHIN
Middle Name:
Last Name:RASHIDI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9225 SW HALL BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-6794
Mailing Address - Country:US
Mailing Address - Phone:503-620-7134
Mailing Address - Fax:503-620-7184
Practice Address - Street 1:9225 SW HALL BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-6794
Practice Address - Country:US
Practice Address - Phone:503-620-7134
Practice Address - Fax:503-620-7184
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR68141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice