Shiv Patel Dental Corp

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

CA49973 Issued in CA

Legal business name

SHIV PATEL DENTAL CORP

Practice address

25617 Dodge Ave
Harbor City, CA 90710-3101

Phone

(310) 835-3144

NPI assigned

Feb 4, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Judy A Dominguez

Title

Office Manager

Phone

(310) 835-3144

Specialties & licenses 1

Addresses

Other names 1

• Harbor Dental Associates Doing business as

Locations

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

{
    "created_epoch": "1359936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1215276746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25617 DODGE AVE",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907103101",
            "telephone_number": "310-835-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25617 DODGE AVE",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907103101",
            "telephone_number": "310-835-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIV PATEL DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-04",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "310-835-3144",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "CA49973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harbor Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sook-Ryul Janice Shim, PHARM.D.
• Brian Kiyoshi Shimizu, D.D.S.
• Minyong Shin, L.AC.
• Philip Shin, MD
• Crystal Michelle Shirreffs, PA-C
• Kenneth M. Shoor, MD
• Suchada Kwunyeun Shu, MD
• Sienne S. Van Enk
• Lulu Silveyra
• Diana Jane Simbol, DDS

• Health Maintenance Organization in Harbor City, CA
• Providers in Harbor City, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; 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.