Pacific Holistic Dental, Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

57466 Issued in CA

Legal business name

PACIFIC HOLISTIC DENTAL, INC.

Practice address

530 W Tefft St
Nipomo, CA 93444-8946

Phone

(805) 929-6814

Fax

(805) 929-2047

NPI assigned

Apr 20, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Edward Shapiro, D.D.SNPI 1023391034

Title

Owner/ Operator

Phone

(805) 929-6814

Specialties & licenses 11

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward Shapiro, D.D.S.

  • Dentist
  • Nipomo, CA
  • NPI 1023391034
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316995200000",
    "number": "1780900480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 W TEFFT ST",
            "city": "NIPOMO",
            "state": "CA",
            "postal_code": "934448946",
            "telephone_number": "805-929-6814",
            "fax_number": "805-929-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 W TEFFT ST",
            "city": "NIPOMO",
            "state": "CA",
            "postal_code": "934448946",
            "telephone_number": "805-929-6814",
            "fax_number": "805-929-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC HOLISTIC DENTAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-20",
        "last_updated": "2011-09-26",
        "status": "A",
        "authorized_official_last_name": "SHAPIRO",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER/ OPERATOR",
        "authorized_official_telephone_number": "805-929-6814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "57466",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "57466",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57466",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "CA",
            "license": "57466",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "57466",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "57466",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "57466",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "57466",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "57466",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon R Olson, DDS
• Romeo S Ortiz, MD
• Ostatnigrosh Williams Chiropractic Professional Corporation
• Pacific Central Coast Health Centers
• Pacific Central Coast Health Centers
• Kenneth Pacofsky, M.D.
• Ben C Palmer, O.D.
• Papageorge Enterprises Inc
• Teresa Louise Pardini, M.S.,LMFT
• Nathaniel Parker, DO

• Dentist in Nipomo, CA
• Providers in Nipomo, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; 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.