Provider Demographics
NPI:1134491194
Name:SHOKOOHI & VAKILI LLC
Entity Type:Organization
Organization Name:SHOKOOHI & VAKILI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRSIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOKOOHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:508-993-1103
Mailing Address - Street 1:68 GRAPE ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-2140
Mailing Address - Country:US
Mailing Address - Phone:508-993-1103
Mailing Address - Fax:508-993-1721
Practice Address - Street 1:68 GRAPE ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-2140
Practice Address - Country:US
Practice Address - Phone:508-993-1103
Practice Address - Fax:508-993-1721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty