Active NPI
Chitra Vijay Shanmugham
- General Practice Dentistry
- Victorville, CA
National Provider Identifier
1730419664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 58869
- Practice address
- 12640 Hesperia Rd
Victorville, CA 92395-7753 - Phone
- (760) 241-3336
- NPI assigned
- Dec 24, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 58869 | CA | Primary |
Addresses
Primary practice location
12640 Hesperia Rd
Victorville, CA 92395-7753
Mailing address
12640 Hesperia Rd
Victorville, CA 92395
Phone (760) 241-3336
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 |
|---|---|---|---|
| 58869 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chitra Shanmugham, D.D.S., Inc | Current | Accepting new patients | |
| B. Deirmenjian, DDS, Inc | General Practice | Past | Accepting new patients |
Interoperability endpoints
- cshanmugham@direct.westerndental.com
Organizations & group practices 2
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.
-
- Dental Clinic/Center
- Campbell, CA
- NPI 1063003812
-
- General Practice Dentistry
- Moreno Valley, CA
- NPI 1245716539
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1261612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263859200000",
"number": "1730419664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12640 HESPERIA RD",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "92395",
"telephone_number": "760-241-3336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12640 HESPERIA RD",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923957753",
"telephone_number": "760-241-3336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANMUGHAM",
"first_name": "CHITRA",
"middle_name": "VIJAY",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-24",
"last_updated": "2010-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "58869",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.