Provider Demographics
NPI:1316363070
Name:SHOKOOHI & VAKILI, II LLC
Entity Type:Organization
Organization Name:SHOKOOHI & VAKILI, II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOKOOHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:978-521-1999
Mailing Address - Street 1:76 MERRIMACK ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6245
Mailing Address - Country:US
Mailing Address - Phone:978-521-1999
Mailing Address - Fax:978-521-1099
Practice Address - Street 1:76 MERRIMACK ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6245
Practice Address - Country:US
Practice Address - Phone:978-521-1999
Practice Address - Fax:978-521-1099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-05
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN217721223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty