Active NPI
Shalaby Professional Dental Corporation
- Dental Clinic/Center
- Laguna Hills, CA
National Provider Identifier
1760091383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Clinic/Center
- Legal business name
- SHALABY PROFESSIONAL DENTAL CORPORATION
- Practice address
- 24953 Paseo de Valencia Ste 2C
Laguna Hills, CA 92653-4337 - Phone
- (949) 441-5617
- NPI assigned
- Jul 29, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tamer Shalaby, DDS
- Title
- President
- Phone
- (949) 441-5617
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Primary |
Addresses
Primary practice location
24953 Paseo de Valencia Ste 2C
Laguna Hills, CA 92653-4337
Mailing address
24953 Paseo de Valencia Ste 2C
Laguna Hills, CA 92653-4337
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DDS55911 | Other | CA | DENTIST LICENSE |
National Provider Directory
National Provider DirectoryLocations
24953 Paseo de Valencia
Ste 2C
Laguna Hills, CA 92653
Phone (949) 441-5617
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Dentist
- Laguna Hills, CA
- NPI 1518711191
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595980800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1706054400000",
"number": "1760091383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24953 PASEO DE VALENCIA STE 2C",
"city": "LAGUNA HILLS",
"state": "CA",
"postal_code": "926534337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24953 PASEO DE VALENCIA STE 2C",
"city": "LAGUNA HILLS",
"state": "CA",
"postal_code": "926534337",
"telephone_number": "949-441-5617"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHALABY PROFESSIONAL DENTAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2020-07-29",
"last_updated": "2024-01-24",
"certification_date": "2024-01-24",
"status": "A",
"authorized_official_last_name": "SHALABY",
"authorized_official_first_name": "TAMER",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "949-441-5617",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTIST LICENSE",
"identifier": "DDS55911",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Laguna Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.