Provider Demographics
NPI:1356442859
Name:OSKOUI, MALEKSHAH M (DMD, CAGS, MSD)
Entity Type:Individual
Prefix:DR
First Name:MALEKSHAH
Middle Name:M
Last Name:OSKOUI
Suffix:
Gender:M
Credentials:DMD, CAGS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 WILD LILAC
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-2831
Mailing Address - Country:US
Mailing Address - Phone:949-929-7424
Mailing Address - Fax:949-679-1335
Practice Address - Street 1:171 WILD LILAC
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-2831
Practice Address - Country:US
Practice Address - Phone:949-679-1330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA491731223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1046OtherDELTA DENTAL OF NEW JERSE
CAX37561OtherBLUE CROSS OF MA
CA008276OtherDELTA PMI