Provider Demographics
NPI:1922408830
Name:SHAMSIAN, SHAHRIYAR (DDS)
Entity Type:Individual
Prefix:
First Name:SHAHRIYAR
Middle Name:
Last Name:SHAMSIAN
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 1:17200 QUESAN PL
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3934
Mailing Address - Country:US
Mailing Address - Phone:818-674-8487
Mailing Address - Fax:
Practice Address - Street 1:17200 QUESAN PL
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3934
Practice Address - Country:US
Practice Address - Phone:818-674-8487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63793122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist