Provider Demographics
NPI:1871710475
Name:SHUSTER, VLADIMIR V (DMD)
Entity type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:V
Last Name:SHUSTER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3113 GEARY BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3316
Mailing Address - Country:US
Mailing Address - Phone:415-876-3636
Mailing Address - Fax:415-876-3633
Practice Address - Street 1:3113 GEARY BLVD
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3316
Practice Address - Country:US
Practice Address - Phone:415-517-4726
Practice Address - Fax:415-665-0539
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA545331223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics