Provider Demographics
NPI:1942447461
Name:HOGHOOGHI, SHAHRIAR (DMD)
Entity Type:Individual
Prefix:
First Name:SHAHRIAR
Middle Name:
Last Name:HOGHOOGHI
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:PO BOX 541421
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33454-1421
Mailing Address - Country:US
Mailing Address - Phone:561-483-9118
Mailing Address - Fax:561-483-2328
Practice Address - Street 1:4105 PEMBROKE ROAD
Practice Address - Street 2:DEPARTMENT OF HEALTH
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020
Practice Address - Country:US
Practice Address - Phone:954-985-4818
Practice Address - Fax:954-985-4820
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN14866122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist