Shaza Shanabo, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48548 Issued in CA

Practice address

14607 Ramona Blvd Ste B
Baldwin Park, CA 91706-3465

Phone

(626) 960-5108

NPI assigned

Sep 28, 2007

Last updated

Oct 26, 2020By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Shanabo Dental Corporation

  dba no

  • Dental Clinic/Center
  • Baldwin Park, CA
  • NPI 1801453337
  Authorized official Same address or phone

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1316134893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 CALLE MORENO",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733991",
            "telephone_number": "909-438-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14607 RAMONA BLVD STE B",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063465",
            "telephone_number": "626-960-5108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15679 Shantung Ave",
            "address_purpose": "LOCATION",
            "city": "Chino Hills",
            "state": "CA",
            "postal_code": "917092823",
            "country_code": "US",
            "telephone_number": "909-636-3632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANABO",
        "first_name": "SHAZA",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-28",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "48548",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pratik Shah, D.O.
• Preeti P. Shah, MD
• Rupal Shah, PHARMD.
• Shilpa Miniyar Shah, MD
• Shanabo Dental Corporation (no)
• Shanti Prakash Inc (Advanced Dialysis Center)
• Chris J Shean, MD
• Brian W.C. Shen, MD
• Mary E Sheridan, CNM
• Lilly Fong Shimabukuro, PHARM.D

• General Practice Dentistry in Baldwin Park, CA
• Providers in Baldwin Park, 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 Oct 26, 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.