Provider Demographics
NPI:1285837781
Name:SHOKER DENTAL INC
Entity Type:Organization
Organization Name:SHOKER DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVINDER
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHOKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-713-7333
Mailing Address - Street 1:3890 MOWRY AVE
Mailing Address - Street 2:SUITE # 201
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1440
Mailing Address - Country:US
Mailing Address - Phone:510-713-7333
Mailing Address - Fax:
Practice Address - Street 1:3890 MOWRY AVE
Practice Address - Street 2:SUITE # 201
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1440
Practice Address - Country:US
Practice Address - Phone:510-713-7333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38600122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB 38600-02OtherDENTICAL