Nikita Shams
Dentist in Los Angeles, CA. Individual provider (NPI-1).
NPI number1053935486
StatusActive
Last updated in NPPESJan 12, 2022
Details
- NPI
- 1053935486
- Entity type
- Individual (NPI-1)
- Name
- Nikita Shams
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 1, 2020
- Certification date
- Jan 12, 2022
- Last updated
- Jan 12, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | DDS107015 | CA | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
11301 Wilshire BlvdLos Angeles, CA 90073-1003
Phone 310-478-3711
Mailing address
25 VisaliaIrvine, CA 92602-1095
Other practice locations
714 Tiverton Ave
Los Angeles, CA 90095-8361
Los Angeles, CA 90095-8361
Phone 978-931-0825
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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