Alan Shaw, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

62391 Issued in CA

Practice address

18800 Main St Ste 205
Huntington Beach, CA 92648-1718

Phone

(714) 841-4954

Fax

(714) 841-4964

NPI assigned

Jun 30, 2011

Last updated

Oct 10, 2018By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Ocean Oral and Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Huntington Beach, CA
  • NPI 1386348621
  NPD Authorized official
• Rick J. Berrios, DDS, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Huntington Beach, CA
  • NPI 1437456670
  NPD (past)

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1235426149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18800 MAIN ST STE 205",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926481718",
            "telephone_number": "714-841-4954",
            "fax_number": "714-841-4964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18800 MAIN ST STE 205",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926481718",
            "telephone_number": "714-841-4954",
            "fax_number": "714-841-4964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 Newport Blvd Ste C",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926272701",
            "country_code": "US",
            "telephone_number": "949-515-4935",
            "fax_number": "949-515-4981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-30",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "62391",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "150844",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Elizabeth Shapiro, RN
• Jonathan Lawrence Shapiro, DMD
• Sharifian and Huston Dental Corporation (Beach Dental Group)
• Victoria Cilluffo Sharma, LCSW
• Aimee Lynn Shaw
• Amanda Shaw, PMHNP
• David G Shaw, DC
• Montgomery Shaw
• Payton Ann Shaw
• Louay Shawesh, MD

• Oral and Maxillofacial Surgery (Dentist) in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.