# SHAHRESTANI SHADOW MOUNTAIN SMILES DENTISTRY, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609331826
- **Authorized official:** ALI SHAHRESTANI (OWNER)
- **Authorized official phone:** (714) 845-8500

## Contact information

- **Practice address:** 6485 N DECATUR BLVD STE 150, LAS VEGAS, NV 89131-2989
- **Practice address phone:** (702) 846-5745
- **Practice address fax:** (702) 832-1495
- **Mailing address:** 17000 RED HILL AVE, IRVINE, CA 92614-5626
- **Mailing address phone:** (714) 845-8500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 02/01/2019
- **Last updated:** 02/01/2019