Provider Demographics
NPI:1760502348
Name:MASHHOON, STEPHEN AMIR (DDS)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:AMIR
Last Name:MASHHOON
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 1:5450 THORNWOOD DR STE B
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-1222
Mailing Address - Country:US
Mailing Address - Phone:408-360-0270
Mailing Address - Fax:408-360-0275
Practice Address - Street 1:5450 THORNWOOD DR STE B
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-1222
Practice Address - Country:US
Practice Address - Phone:408-360-0270
Practice Address - Fax:408-360-0275
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38560122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist