Provider Demographics
NPI:1003959727
Name:HASHEMIAN, SHERVIN TONY (DDS)
Entity type:Individual
Prefix:DR
First Name:SHERVIN
Middle Name:TONY
Last Name:HASHEMIAN
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 1:266 AMBROISE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT COAST
Mailing Address - State:CA
Mailing Address - Zip Code:92657-0131
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:266 AMBROISE
Practice Address - Street 2:
Practice Address - City:NEWPORT COAST
Practice Address - State:CA
Practice Address - Zip Code:92657-0131
Practice Address - Country:US
Practice Address - Phone:480-686-5963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD4790122300000X
CA105430122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist