Individual provider Active NPI

Christine Shehata, D.D.S.

  • Dentist
  • Montebello, CA
National Provider Identifier
1588007108
Registry record updated Sep 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
61740 Issued in CA
Practice address
1451 N Montebello Blvd
Montebello, CA 90640
Phone
(323) 724-9955
NPI assigned
Apr 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 61740 CA Primary
Public Health Dentistry 1223D0001X 61740 CA
General Practice Dentistry 1223G0001X 61740 CA

Addresses

Primary practice location

1451 N Montebello Blvd
Montebello, CA 90640

Mailing address

1451 N Montebello Blvd
Montebello, CA 90640
Phone (323) 724-9955

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151009000764 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3779891833

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61740CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Christine Shehata, DDS, Inc General Practice CurrentSince Oct 11, 2020 Accepting new patients

Locations

432 W Foothill Blvd
Glendora, CA 91741
Phone (626) 335-1507

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": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1588007108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 N MONTEBELLO BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "90640",
            "telephone_number": "323-724-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 N MONTEBELLO BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "90640",
            "telephone_number": "323-724-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEHATA",
        "first_name": "CHRISTINE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-12",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "61740",
            "primary": true
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "CA",
            "license": "61740",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61740",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

Verify at the official NPI Registry.