Active NPI
Shawn Mucho, DDS
- Dentist
- Ukiah, CA
National Provider Identifier
1518037407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 52100
- Practice address
- 333 Laws Ave
Ukiah, CA 95482-6540 - Phone
- (707) 263-0196
- Fax
- (707) 263-1439
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 52100 | CA | Primary |
Addresses
Primary practice location
333 Laws Ave
Ukiah, CA 95482-6540
Mailing address
333 Laws Ave
Ukiah, CA 95482-6540
Phone (707) 263-0196
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131202000768 | CA | Order and Referring Only - Oral Surgery | 8325274061 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51200 | CA | MD | Marriage & Family Therapist |
| 52100 | CA | MD | Physician Assistant |
Interoperability endpoints
- smucho344433@direct.ochin.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1518037407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 LAWS AVE",
"city": "UKIAH",
"state": "CA",
"postal_code": "954826540",
"telephone_number": "707-263-0196",
"fax_number": "707-263-1439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 LAWS AVE",
"city": "UKIAH",
"state": "CA",
"postal_code": "954826540",
"telephone_number": "707-263-0196",
"fax_number": "707-263-1439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUCHO",
"first_name": "SHAWN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "52100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.