Icare Dental Group, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48995 Issued in CA

Legal business name

ICARE DENTAL GROUP, INC

Practice address

4055 Evergreen Village SQ
Suite 240
San Jose, CA 95135-1748

Phone

(408) 223-9118

Fax

(408) 223-9228

NPI assigned

May 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Chungling Shaaw, D. D. S.

Title

Officer

Phone

(408) 223-9118

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245441617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 EVERGREEN VILLAGE SQ",
            "address_2": "SUITE 240",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951351748",
            "telephone_number": "408-223-9118",
            "fax_number": "408-223-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 EVERGREEN VILLAGE SQ",
            "address_2": "SUITE 240",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951351748",
            "telephone_number": "408-223-9118",
            "fax_number": "408-223-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICARE DENTAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAAW",
        "authorized_official_first_name": "CHUNGLING",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "408-223-9118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D. D. S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ginikachi Ibe
• Mohamed Abdullahi Ibrahim, NEMT
• Safia Osman Ibrahim
• Yazeed Ibrahim
• Said M Ibrahimi, MD
• Icare Pharmacy Inc
• David M. Ichimura, D.D.S.
• Michael Ichinaga, PH.D.
• Iconic Eyes Optometry
• Mary R. Idso, MD

• General Practice Dentistry in San Jose, CA
• Providers in San Jose, 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 Aug 22, 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.