Provider Demographics
NPI:1285637264
Name:SALIMY, SHAHRAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHAHRAM
Middle Name:
Last Name:SALIMY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 BISON AVE
Mailing Address - Street 2:STE A-2
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-4261
Mailing Address - Country:US
Mailing Address - Phone:949-640-8880
Mailing Address - Fax:949-640-8882
Practice Address - Street 1:1220 BISON AVE
Practice Address - Street 2:STE A-2
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-4261
Practice Address - Country:US
Practice Address - Phone:949-640-8880
Practice Address - Fax:949-640-8882
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2011-11-16
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-20
Provider Licenses
StateLicense IDTaxonomies
CA56657122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist