Provider Demographics
NPI:1700845393
Name:SHAHRIAR HOGHOOGHI DMD, PA
Entity Type:Organization
Organization Name:SHAHRIAR HOGHOOGHI DMD, PA
Other - Org Name:DENTAL ASSOCIATES OF BOCA GREENS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHRIAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HOGHOOGHI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-483-9118
Mailing Address - Street 1:19635 STATE ROAD 7
Mailing Address - Street 2:SUITE 51
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-4743
Mailing Address - Country:US
Mailing Address - Phone:561-483-9118
Mailing Address - Fax:
Practice Address - Street 1:19635 STATE ROAD 7
Practice Address - Street 2:SUITE 51
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-4743
Practice Address - Country:US
Practice Address - Phone:561-483-9118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL148661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty