Mondana Nicole Shamsazar, DDS
Dentist in Goodyear, AZ. Individual provider (NPI-1).
NPI number1831746932
StatusActive
Last updated in NPPESJul 3, 2024
Details
- NPI
- 1831746932
- Entity type
- Individual (NPI-1)
- Name
- Ms. Mondana Nicole Shamsazar
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 22, 2019
- Certification date
- Jul 3, 2024
- Last updated
- Jul 3, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | D011727 | AZ | Yes |
| 1223G0001X | Dentist, General Practice | 16999 | MD | |
| 1223G0001X | Dentist, General Practice | D011727 | AZ |
Practice location
500 N Estrella Pkwy Ste B1Goodyear, AZ 85338-4136
Phone 623-688-5408
Mailing address
15260 W McDowell RdGoodyear, AZ 85395-2530
Phone 623-207-7838
Other practice locations
15260 W McDowell Rd
Goodyear, AZ 85395-2530
Goodyear, AZ 85395-2530
Phone 623-207-7838
20800 W Market St Ste 107
Buckeye, AZ 85396-8040
Buckeye, AZ 85396-8040
Phone 623-900-9996
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