Persona Dental Group of Shaw DDS, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

59455 Issued in CA

Legal business name

PERSONA DENTAL GROUP OF SHAW DDS, INC.

Practice address

8221 Rochester Ave Ste 110
Rancho Cucamonga, CA 91730-0721

Phone

(310) 347-6172

NPI assigned

Mar 13, 2012

Last updated

Mar 13, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James Chung Shaw, DDSNPI 1386950954

Title

Owner

Phone

(310) 347-6172

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James Chung Shaw, D.D.S.

  • Dentist
  • Rancho Cucamonga, CA
  • NPI 1386950954
  NPD (past) Authorized official

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331596800000",
    "number": "1184999815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8221 ROCHESTER AVE STE 110",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300721",
            "telephone_number": "310-347-6172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8221 ROCHESTER AVE STE 110",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300721",
            "telephone_number": "310-347-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONA DENTAL GROUP OF SHAW DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-13",
        "last_updated": "2012-03-13",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "CHUNG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-347-6172",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Luis Avellana Perrenoud
• Sarah Michelle Perri
• James B. Perry, RPH.
• Keysha Perry
• Tai S Perry, BA
• Peter C Yanes DDS Inc
• Tracy Peterlin
• Danielle Peters, BCBA
• Melinda J. Peters, PTA
• Michael Peters, BCBA

• General Practice Dentistry in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; 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.