Provider Demographics
NPI:1437375417
Name:ZANDKARIMI, SHAHRIYAR (DDS)
Entity Type:Individual
Prefix:
First Name:SHAHRIYAR
Middle Name:
Last Name:ZANDKARIMI
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 1:240 W MISSION AVE
Mailing Address - Street 2:SUITES A&B
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-1700
Mailing Address - Country:US
Mailing Address - Phone:760-747-7000
Mailing Address - Fax:760-747-2286
Practice Address - Street 1:240 W MISSION AVE
Practice Address - Street 2:SUITES A&B
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-1700
Practice Address - Country:US
Practice Address - Phone:760-747-7000
Practice Address - Fax:760-747-2286
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA397311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice