Sheldon Xiaochen Lu DMD Inc

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

64765 Issued in CA

Legal business name

SHELDON XIAOCHEN LU DMD INC

Practice address

17501 Irvine Blvd
Suite 101
Tustin, CA 92780-3103

Phone

(714) 835-4441

Fax

(714) 835-0188

NPI assigned

Jul 7, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sheldon Xiaochen Lu, DMDNPI 1306039169

Title

Owner

Phone

(714) 835-4441

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Sheldon Xiaochen Lu DMD Inc Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sheldon Xiaochen Lu, DMD

  • Periodontics
  • Orange, CA
  • NPI 1306039169
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1417479890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17501 IRVINE BLVD STE 101",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803147",
            "telephone_number": "714-835-4441",
            "fax_number": "714-835-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17501 IRVINE BLVD",
            "address_2": "SUITE 101",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803103",
            "telephone_number": "714-835-4441",
            "fax_number": "714-835-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELDON XIAOCHEN LU DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LU",
        "authorized_official_first_name": "SHELDON",
        "authorized_official_middle_name": "XIAOCHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-835-4441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61156",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56342",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "64765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528732",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sheldon Xiaochen Lu DMD Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Sheldon Xiaochen Lu DMD Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Molly Elizabeth Sharpe
• Irene Shea, RBT
• Makoa D Shefte
• Shek on Gun OD Inc (Central Orange County Optometry)
• Danial Hanh Shelburne
• Emily Sunavy Shepherd, DPT
• Stephen Robert Shepherd, D.D.S.
• Citlalitl Santos Sheppard, LCSW
• Coralyn Elizabeth Sheridan, LMFT
• Stephanie Shieh, PHARMD

• Periodontics in Tustin, CA
• Providers in Tustin, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.