Wynn Shang, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS103456 Issued in CA

Practice address

21222 Beach Blvd
Huntington Beach, CA 92648-5411

Phone

(949) 381-1635

NPI assigned

Jul 21, 2017

Reactivated

Sep 6, 2018

Last updated

Jul 29, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shang DMD Dental Corporation

  • Dental Clinic/Center
  • Huntington Beach, CA
  • NPI 1235748120
  NPD Authorized official

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

{
    "created_epoch": "1500595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1215450267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13208 MYFORD RD APT 341",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927829113",
            "telephone_number": "909-570-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21222 BEACH BLVD",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926485411",
            "telephone_number": "949-381-1635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANG",
        "first_name": "WYNN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-21",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "deactivation_date": "2018-06-06",
        "reactivation_date": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS103456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ebtisam I Shalaby-Saleh, RPH
• Shalini Shah DDS and Associates (Dental Associates of Huntington Beach)
• Shalini Shah DDS Inc. (A Kids Dentist)
• Shamrock Medical, LLC
• Shang DMD Dental Corporation
• Amber Shannon, RN, BSN, CMC, HPCN
• Kathleen Noelle Shannon, M.A., .M.F.C.
• Michael J. Shannon, BC-HIS
• Yen Yenta Shao, DMD
• Barbara Elizabeth Shapiro, RN

• General Practice Dentistry in Huntington Beach, CA
• Providers in Huntington Beach, 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 Jul 29, 2020; 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.