Individual provider Active NPI

Jonathan Harry Shapiro, DMD, MDSC

  • Endodontics
  • Santa Monica, CA
National Provider Identifier
1295230225
Registry record updated Jul 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
103987 Issued in CA
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, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220806000028 CT Order and Referring Only - DentistPractitioner - Dentist 6608258710

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103987CAMDGeneral Practice Dentistry
13402CTMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Yigal Zibari, D.D.S., a Professional Dental Corporation Endodontics PastSince Apr 9, 2024 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.

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

Verify at the official NPI Registry.