Individual provider Active NPI

Chun-Ting Shang, DDS

  • Pediatric Dentistry
  • Rolling Hills Estates, CA
National Provider Identifier
1356545883
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
56485 Issued in CA
Practice address
550 Deep Valley Dr Ste 345
Rolling Hills Estates, CA 90274-7603
Phone
(310) 377-4551
Fax
(310) 541-6042
NPI assigned
Jun 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 56485 CA Primary

Addresses

Primary practice location

550 Deep Valley Dr Ste 345
Rolling Hills Estates, CA 90274-7603

Mailing address

550 Deep Valley Dr Ste 345
Rolling Hills Estates, CA 90274-7603
Phone (310) 377-4551

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
56485CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan Lo D.D.S., Inc. Pediatric Dentistry PastSince Nov 9, 2021 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": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1356545883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 DEEP VALLEY DR STE 345",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902747603",
            "telephone_number": "310-377-4551",
            "fax_number": "310-541-6042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 DEEP VALLEY DR STE 345",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902747603",
            "telephone_number": "310-377-4551",
            "fax_number": "310-541-6042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANG",
        "first_name": "CHUN-TING",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "56485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolling Hills Estates, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.