Organization Active NPI

Shalaby Professional Dental Corporation

  • Dental Clinic/Center
  • Laguna Hills, CA
National Provider Identifier
1760091383
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
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

Updated by the provider on Jan 24, 2024

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
DDS55911OtherCADENTIST LICENSE

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.