Provider Demographics
NPI:1871613448
Name:SHOKRI, MOJGAN (DDS)
Entity type:Individual
Prefix:DR
First Name:MOJGAN
Middle Name:
Last Name:SHOKRI
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 1:6325 TOPANGA CANYON BLVD.
Mailing Address - Street 2:SUITE 228
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367
Mailing Address - Country:US
Mailing Address - Phone:818-225-0093
Mailing Address - Fax:818-854-6060
Practice Address - Street 1:6325 TOPANGA CANYON BLVD.
Practice Address - Street 2:SUITE 228
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367
Practice Address - Country:US
Practice Address - Phone:818-225-0093
Practice Address - Fax:818-854-6060
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA424201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice