Individual provider · NPI-1
Jamileh Taj Shirali, DDS , DMD
Technician/Technologist · Mission Viejo, CA
NPI number1215625959
StatusActive
Last updated in NPPESMay 17, 2023
Details
- NPI
- 1215625959
- Entity type
- Individual (NPI-1)
- Name
- Jamileh Taj Shirali
- Credential
- DDS , DMD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 1, 2023
- Certification date
- May 17, 2023
- Last updated
- May 17, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156F00000X | Technician/Technologist | – | – | Yes |
| 261QR1100X | Clinic/Center, Research | – | – |
Practice location
25662 Aurora WayMission Viejo, CA 92691-4619
Phone 714-403-2703
Mailing address
25662 Aurora WayMission Viejo, CA 92691-4619
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.