Provider Demographics
NPI:1306383096
Name:SHAHIN JAVID DDS INC
Entity Type:Organization
Organization Name:SHAHIN JAVID DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SHAHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JAVID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-222-2242
Mailing Address - Street 1:27420 TOURNEY RD STE 230
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5635
Mailing Address - Country:US
Mailing Address - Phone:661-222-2242
Mailing Address - Fax:661-222-2236
Practice Address - Street 1:27420 TOURNEY RD STE 230A
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5635
Practice Address - Country:US
Practice Address - Phone:661-222-2242
Practice Address - Fax:661-222-2236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-19
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43021261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherDELTA DENTAL