Individual provider Active NPI

James S Shon, DDS

  • General Practice Dentistry
  • Garden Grove, CA
National Provider Identifier
1043744139
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
103052 Issued in CA
Practice address
12752 Garden Grove Blvd Ste 200
Garden Grove, CA 92843-1924
Phone
(714) 636-2595
NPI assigned
Apr 14, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 103052 CA Primary

Addresses

Primary practice location

12752 Garden Grove Blvd Ste 200
Garden Grove, CA 92843-1924

Mailing address

2977 Player LN
Tustin, CA 92782-1522
Phone (213) 284-2245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
103052CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
James Shon DDS Inc. General Practice CurrentSince Sep 5, 2023 Accepting new patients
Anthony D. Nguyen, DDS, Inc PastSince Jul 3, 2018 Accepting new patients

Locations

12752 Garden Grove Blvd
Ste 200
Garden Grove, CA 92843
Phone (714) 636-2595

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1043744139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2977 PLAYER LN",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927821522",
            "telephone_number": "213-284-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12752 GARDEN GROVE BLVD STE 200",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431924",
            "telephone_number": "714-636-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHON",
        "first_name": "JAMES",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-14",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "103052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.