Provider Demographics
NPI:1467951467
Name:SHAGHAYEGH VAKILIAN DDS INC
Entity Type:Organization
Organization Name:SHAGHAYEGH VAKILIAN DDS INC
Other - Org Name:DENTAL SOLUTIONS OF ENCINITAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAGHAYEGH
Authorized Official - Middle Name:
Authorized Official - Last Name:VAKILIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-436-9292
Mailing Address - Street 1:320 SANTA FE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5139
Mailing Address - Country:US
Mailing Address - Phone:760-436-9292
Mailing Address - Fax:760-436-9332
Practice Address - Street 1:320 SANTA FE DR STE 105
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5139
Practice Address - Country:US
Practice Address - Phone:760-436-9292
Practice Address - Fax:760-436-9332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA637711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty