Provider Demographics
NPI:1578185302
Name:DADJOO, SHAAHIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHAAHIN
Middle Name:
Last Name:DADJOO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 W NEES AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-4434
Mailing Address - Country:US
Mailing Address - Phone:832-584-8665
Mailing Address - Fax:
Practice Address - Street 1:5422 W CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-8340
Practice Address - Country:US
Practice Address - Phone:585-275-8315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-14
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1057471223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics