Active NPI
Shawn J. Summers, D.D.S.
- Public Health Dentistry
- North Hollywood, CA
National Provider Identifier
1730235607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- 39893
- Practice address
- 6801 Coldwater Canyon Ave
North Hollywood, CA 91605-5162 - Phone
- (818) 763-1718
- Fax
- (818) 764-4589
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | 39893 | CA | Primary |
Addresses
Primary practice location
6801 Coldwater Canyon Ave
North Hollywood, CA 91605-5162
Mailing address
1239 Larrabee St
#10
West Hollywood, CA 90069-2085
Phone (310) 289-9729
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 |
|---|---|---|---|
| 39893 | CA | MD | Public Health Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730235607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1239 LARRABEE ST",
"address_2": "#10",
"city": "WEST HOLLYWOOD",
"state": "CA",
"postal_code": "900692085",
"telephone_number": "310-289-9729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6801 COLDWATER CANYON AVE",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916055162",
"telephone_number": "818-763-1718",
"fax_number": "818-764-4589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMMERS",
"first_name": "SHAWN",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "CA",
"license": "39893",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Hollywood, 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.