Shepard & Dos Santos Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

License

41704 Issued in CA

Legal business name

SHEPARD & DOS SANTOS DENTAL CORPORATION

Doing business as

Aero Dental Group

Practice address

310 E Grand Ave Ste 102
El Segundo, CA 90245-3871

Phone

(760) 453-5702

NPI assigned

Jan 30, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Amanda Wolf Dos Santos, DA

Title

Ceo

Phone

(424) 277-1138

Specialties & licenses 1

Addresses

Other names 1

• Aero Dental Group Doing business as

Locations

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485734400000",
    "number": "1548707441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E GRAND AVE STE 102",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902453871",
            "telephone_number": "760-453-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E GRAND AVE STE 102",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902453871",
            "telephone_number": "760-453-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPARD & DOS SANTOS DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-30",
        "last_updated": "2017-01-30",
        "status": "A",
        "authorized_official_last_name": "DOS SANTOS",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "WOLF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "424-277-1138",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DA"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "41704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aero Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Baileigh Sheffield
• Sofia Sheibani
• Ruweda Sheikh
• Sarah Sheikhali
• Tatiana Shemiakina
• Akamie Shepherd
• Antonate Shepherd
• Kiara Shepherd
• Gene Victor Sherman, MD
• Ian Sherry

• Dentist in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; 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.