Provider Demographics
NPI:1801012844
Name:SHOKOOHI, CYRUS (DMD)
Entity Type:Individual
Prefix:
First Name:CYRUS
Middle Name:
Last Name:SHOKOOHI
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 1:5920 ROSWELL RD NE
Mailing Address - Street 2:SUITE A-201
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4913
Mailing Address - Country:US
Mailing Address - Phone:404-252-4700
Mailing Address - Fax:404-252-4744
Practice Address - Street 1:5920 ROSWELL RD NE
Practice Address - Street 2:SUITE A-201
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4913
Practice Address - Country:US
Practice Address - Phone:404-252-4700
Practice Address - Fax:404-252-4744
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA114481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice