Provider Demographics
NPI:1073909115
Name:SHAHI, PARISA (DDS, FACP)
Entity Type:Individual
Prefix:DR
First Name:PARISA
Middle Name:
Last Name:SHAHI
Suffix:
Gender:F
Credentials:DDS, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2203
Mailing Address - Country:US
Mailing Address - Phone:408-516-4050
Mailing Address - Fax:
Practice Address - Street 1:455 HICKEY BLVD STE 403
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2630
Practice Address - Country:US
Practice Address - Phone:650-997-3266
Practice Address - Fax:650-997-3569
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA632671223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics