Shira Fenya Scholten, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS106024 Issued in CA

Practice address

1200 S Broadway Apt 302
Los Angeles, CA 90015-4322

Phone

(302) 528-4340

NPI assigned

Jan 17, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Shira Fenya Butt Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 25, 2024 through Jan 25, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1610841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615075200000",
    "number": "1629667266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S BROADWAY APT 302",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900154322",
            "telephone_number": "302-528-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S BROADWAY APT 302",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900154322",
            "telephone_number": "302-528-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOLTEN",
        "first_name": "SHIRA",
        "middle_name": "FENYA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-17",
        "last_updated": "2021-03-07",
        "certification_date": "2021-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "10562",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106024",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS106024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "Axium",
            "affiliation": "N",
            "address_1": "925 W 34th Street Den 102 Apt 302",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900890641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHIRA",
            "last_name": "BUTT",
            "middle_name": "FENYA",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heidi Schoepflin, P.A.-C.
• Li Schoessow, RCP
• Catherine Rose Schofield, RN
• Connor Schofield
• Hannah Lala Schollhammer
• Christina Marie Scholtz, PHD
• Shelly Scholz
• Mary R Schomaker
• Jacob Schonau-Taylor
• Eva Schondorf, M.D.

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.