Yvonne Shu Rodriguez, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

41547 Issued in CA

Practice address

1640 Indian Hill Blvd
Pomona, CA 91767-3728

Phone

(909) 482-4500

Fax

(909) 482-4502

NPI assigned

Nov 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Yvonne Shu D.D.S., Inc

  • General Practice Dentistry
  • Pomona, CA
  • NPI 1366599060
  NPD Authorized official

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1356414411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 INDIAN HILL BLVD",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673728",
            "telephone_number": "909-482-4500",
            "fax_number": "909-482-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 INDIAN HILL BLVD",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673728",
            "telephone_number": "909-482-4500",
            "fax_number": "909-482-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHU RODRIGUEZ",
        "first_name": "YVONNE",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "954876236",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G9220601",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D41547",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "771913",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY FAMILIES PROVIDER",
            "identifier": "B41547",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dominick Shoha
• Seyedshayan Shojaei
• Daniel Shon, DMD
• Justin Shon
• Victoria L Shook, M.D.
• Gabriela Sibrian, MD
• Sakeena Siddiq
• Aliyah Siddiqi
• Nazia Siddiqi, M.D.
• Aemen Zia Siddiqui

• General Practice Dentistry in Pomona, CA
• Providers in Pomona, 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 Mar 16, 2021; 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.