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Individual

DR. SHAHRIAR H AGAHI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
30451 AVENIDA DE LAS FLORES UNIT C, RANCHO SANTA MARGARITA, CA 92688-3953
(949) 637-3976
Mailing address
30451 AVENIDA DE LAS FLORES UNIT C, RANCHO SANTA MARGARITA, CA 92688-3953
(949) 298-8668
(949) 298-8667

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
101025
CA
1223G0001X
General Practice Dentistry
101025
CA
1223P0300X
Periodontics
Primary
101025
CA
1223P0300X
Periodontics
S4-121
NV

Other

Enumeration date
06/13/2016
Last updated
02/15/2022
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