Provider Demographics
NPI:1891985693
Name:SHOJAI, SHERVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHERVIN
Middle Name:
Last Name:SHOJAI
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 1:30 PROSPECT ST
Mailing Address - Street 2:PO BOX 932
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940
Mailing Address - Country:US
Mailing Address - Phone:973-360-9800
Mailing Address - Fax:
Practice Address - Street 1:7 PROSPECT PL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-1911
Practice Address - Country:US
Practice Address - Phone:973-360-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDIO19647122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist