Individual provider Active NPI

Walter Scott Shew, D.D.S.

  • Dentist
  • Brea, CA
National Provider Identifier
1376670794
Registry record updated Oct 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
37919 Issued in CA
Practice address
255 W Central Ave Ste 202
Brea, CA 92821-3373
Phone
(714) 529-1311
Fax
(714) 529-1489
NPI assigned
Feb 27, 2007
Last updated
Oct 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 37919 CA Primary

Addresses

Primary practice location

255 W Central Ave Ste 202
Brea, CA 92821-3373

Mailing address

255 W Central Ave Ste 202
Brea, CA 92821-3373
Phone (714) 529-1311

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
37919CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1376670794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W CENTRAL AVE STE 202",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213373",
            "telephone_number": "714-529-1311",
            "fax_number": "714-529-1489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W CENTRAL AVE STE 202",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213373",
            "telephone_number": "714-529-1311",
            "fax_number": "714-529-1489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEW",
        "first_name": "WALTER",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "37919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; 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.