Provider Demographics
NPI:1265784367
Name:AARUP, SHAHRZAD DOULATSHAHI (DDS)
Entity type:Individual
Prefix:DR
First Name:SHAHRZAD
Middle Name:DOULATSHAHI
Last Name:AARUP
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-1854
Mailing Address - Country:US
Mailing Address - Phone:909-469-8641
Mailing Address - Fax:909-706-3800
Practice Address - Street 1:309 E 2ND ST
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-1854
Practice Address - Country:US
Practice Address - Phone:909-469-8641
Practice Address - Fax:909-706-3800
Is Sole Proprietor?:No
Enumeration Date:2012-10-12
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX284501223G0001X
CASP2901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice