Active NPI
Shumin Wen, DDS
- General Practice Dentistry
- Los Angeles, CA
National Provider Identifier
1689742082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 48058
- Practice address
- 355 W Manchester Ave
Los Angeles, CA 90003-3327 - Phone
- (323) 751-4100
- Fax
- (323) 751-2853
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 48058 | CA | Primary |
Addresses
Primary practice location
355 W Manchester Ave
Los Angeles, CA 90003-3327
Mailing address
1038 Park Ave
Arcadia, CA 91007-6949
Phone (626) 445-7882
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48058 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Dental Services, Inc. | General Practice | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Los Angeles, CA
- NPI 1326109646
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689742082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1038 PARK AVE",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910076949",
"telephone_number": "626-445-7882",
"fax_number": "626-445-7882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 W MANCHESTER AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900033327",
"telephone_number": "323-751-4100",
"fax_number": "323-751-2853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEN",
"first_name": "SHUMIN",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "48058",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.