Organization Active NPI

Harin Shodhan a Professional Dental Corp

  • Dentist
  • Brea, CA
National Provider Identifier
1639310717
Registry record updated Mar 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
46966 Issued in CA
Legal business name
HARIN SHODHAN A PROFESSIONAL DENTAL CORP
Practice address
936 E Imperial Hwy
Brea, CA 92821-5612
Phone
(714) 990-4911
Fax
(714) 990-5883
NPI assigned
Mar 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2009

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

Authorized official

Name
Harin P Shodhan, D.D.S
Title
Owner
Phone
(714) 990-4911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 46966 CA Primary

Addresses

Primary practice location

936 E Imperial Hwy
Brea, CA 92821-5612

Mailing address

936 E Imperial Hwy
Brea, CA 92821-5612
Phone (714) 990-4911

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237334400000",
    "number": "1639310717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 E IMPERIAL HWY",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928215612",
            "telephone_number": "714-990-4911",
            "fax_number": "714-990-5883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 E IMPERIAL HWY",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928215612",
            "telephone_number": "714-990-4911",
            "fax_number": "714-990-5883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARIN SHODHAN A PROFESSIONAL DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-18",
        "last_updated": "2009-03-18",
        "status": "A",
        "authorized_official_last_name": "SHODHAN",
        "authorized_official_first_name": "HARIN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-990-4911",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "46966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2009; 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.