Provider Demographics
NPI:1790708766
Name:SHAHRIAR, SHIRIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHIRIN
Middle Name:
Last Name:SHAHRIAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 CENTRE ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-1640
Mailing Address - Country:US
Mailing Address - Phone:617-332-3100
Mailing Address - Fax:
Practice Address - Street 1:290 CENTRE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-1640
Practice Address - Country:US
Practice Address - Phone:617-332-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA186821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice