Dennis Wayne Shults, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A6638 Issued in CA

Practice address

710 N. Brea Blvd
Ste G
Brea, CA 92821

Phone

(714) 671-1150

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• SC Medical, Inc.

  • Urgent Care Clinic/Center
  • Santa Clarita, CA
  • NPI 1992078000
  Medicare reassignment NPD
• SC Medical, Inc.

  • Urgent Care Clinic/Center
  • Valencia, CA
  • NPI 1346834694
  NPD
• Nuestra Angel Medical Center Inc

  • Physical Medicine & Rehabilitation Physician
  • Los Angeles, CA
  • NPI 1689625022
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1043370026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3010",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910316718",
            "telephone_number": "562-733-1467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N. BREA BLVD",
            "address_2": "STE G",
            "city": "BREA",
            "state": "CA",
            "postal_code": "92821",
            "telephone_number": "714-671-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULTS",
        "first_name": "DENNIS",
        "middle_name": "WAYNE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6638",
            "primary": true
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "CA",
            "license": "20A6638",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walter Scott Shew, D.D.S.
• Kylee Shibuya
• Dania Melody Shiekh
• Francis Davis Shih, M.D.
• David Shoemaker A Shoemaker, LMFT
• Garrick Shum
• Phuong Khanh Shum
• Anna Shurilla, BA SLPA
• Angelia Sidarta, D.O.
• Anwer Siddiqi

• Family Medicine Physician in Brea, CA
• Providers in Brea, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.