Individual provider Active NPI

Shrrell L Byard, D.D.S

  • General Practice Dentistry
  • Santee, CA
National Provider Identifier
1336124122
Registry record updated Nov 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
57127 Issued in CA
Practice address
246 Town Center Pkwy
Santee, CA 92071-5803
Phone
(619) 312-6006
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901019110 MI
General Practice Dentistry 1223G0001X 57127 CA Primary

Addresses

Primary practice location

246 Town Center Pkwy
Santee, CA 92071-5803

Mailing address

2627 Shoup Dr
San Diego, CA 92110-4268
Phone (760) 807-4841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
57127CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jadali-Araghi and Nosti Dental Corporation General Practice 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259539200000",
    "number": "1336124122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 SHOUP DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104268",
            "telephone_number": "760-807-4841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 TOWN CENTER PKWY",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920715803",
            "telephone_number": "619-312-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYARD",
        "first_name": "SHRRELL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2009-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019110",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santee, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2009; 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.