Individual provider Active NPI

Dustin Michael Schrock, DDS

  • Dentist
  • El Segundo, CA
National Provider Identifier
1629993258
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS113584 Issued in CA
Practice address
630 N Pacific Coast Hwy Ste 15
El Segundo, CA 90245-3435
Phone
(310) 361-2258
NPI assigned
Aug 12, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS113584 CA Primary

Addresses

Primary practice location

630 N Pacific Coast Hwy Ste 15
El Segundo, CA 90245-3435

Mailing address

1380 Veteran Ave Apt 404
Los Angeles, CA 90024-4830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1786492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1629993258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 VETERAN AVE APT 404",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N PACIFIC COAST HWY STE 15",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902453435",
            "telephone_number": "310-361-2258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROCK",
        "first_name": "DUSTIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-12",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS113584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.