Active NPI
Jonathan Harry Shapiro, DMD, MDSC
- Endodontics
- Santa Monica, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 103987
- Practice address
- 2901 Wilshire Blvd Ste 201
Santa Monica, CA 90403-4905 - Phone
- (310) 564-3636
- NPI assigned
- Mar 30, 2018
- Last updated
- Jul 19, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 103987 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | 13402 | CT | |
| Endodontics | 1223E0200X | 103987 | CA | Primary |
Addresses
Primary practice location
2901 Wilshire Blvd Ste 201
Santa Monica, CA 90403-4905
Mailing address
1515 1St St
Manhattan Beach, CA 90266-7001
Phone (310) 702-3970
Other practice location 1
3742 Katella Ave Ste 301
Los Alamitos, CA 90720-3172
Phone (562) 594-3838
Other practice location 2
1200 Rosecrans Ave Ste 101
Manhattan Beach, CA 90266-2470
Phone (310) 615-1022
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220806000028 | CT | Order and Referring Only - Dentist | 6608258710 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103987 | CA | MD | General Practice Dentistry |
| 13402 | CT | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yigal Zibari, D.D.S., a Professional Dental Corporation | Endodontics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Manhattan Beach Endodontics
- Endodontics
- Manhattan Beach, CA
- NPI 1073365342
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752883200000",
"number": "1295230225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 1ST ST",
"city": "MANHATTAN BEACH",
"state": "CA",
"postal_code": "902667001",
"telephone_number": "310-702-3970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 WILSHIRE BLVD STE 201",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904034905",
"telephone_number": "310-564-3636"
}
],
"practiceLocations": [
{
"address_1": "3742 Katella Ave Ste 301",
"address_purpose": "LOCATION",
"city": "Los Alamitos",
"state": "CA",
"postal_code": "907203172",
"country_code": "US",
"telephone_number": "562-594-3838",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1200 Rosecrans Ave Ste 101",
"address_purpose": "LOCATION",
"city": "Manhattan Beach",
"state": "CA",
"postal_code": "902662470",
"country_code": "US",
"telephone_number": "310-615-1022",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHAPIRO",
"first_name": "JONATHAN",
"middle_name": "HARRY",
"name_prefix": "Dr.",
"credential": "DMD, MDSC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-30",
"last_updated": "2025-07-19",
"certification_date": "2025-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "103987",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CT",
"license": "13402",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "103987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2025; 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.