Dentireal, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

37337 Issued in CA

Legal business name

DENTIREAL, INC.

Practice address

3785 Alton Pkwy
Irvine, CA 92606-8293

Phone

(949) 475-1898

Fax

(949) 475-1930

NPI assigned

Feb 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Eddy Shubin Shea, D.D.S.

Title

Owner

Phone

(949) 475-1898

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223337600000",
    "number": "1215063383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3785 ALTON PKWY",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926068293",
            "telephone_number": "949-475-1898",
            "fax_number": "949-475-1930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3785 ALTON PKWY",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926068293",
            "telephone_number": "949-475-1898",
            "fax_number": "949-475-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTIREAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2008-10-07",
        "status": "A",
        "authorized_official_last_name": "SHEA",
        "authorized_official_first_name": "EDDY",
        "authorized_official_middle_name": "SHUBIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-475-1898",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "37337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.