Individual provider Active NPI

Shawn Hofkes, D.D.S.

  • General Practice Dentistry
  • Cerritos, CA
National Provider Identifier
1780986604
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
59962 Issued in CA
Practice address
11480 South St
201
Cerritos, CA 90703-6645
Phone
(562) 584-4082
NPI assigned
Nov 29, 2010
Last updated
Nov 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 59962 CA Primary

Addresses

Primary practice location

11480 South St
201
Cerritos, CA 90703-6645

Mailing address

11480 South St
201
Cerritos, CA 90703-6645

Other practice location 1

122 Agate Ave A
201
Newport Beach, CA 92662-9266
Phone (949) 630-0143

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
59962CAMDGeneral Practice Dentistry

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1290988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1780986604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11480 SOUTH ST",
            "address_2": "201",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11480 SOUTH ST",
            "address_2": "201",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036645",
            "telephone_number": "562-584-4082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "122 Agate Ave A",
            "address_2": "201",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926629266",
            "country_code": "US",
            "telephone_number": "949-630-0143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOFKES",
        "first_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-29",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.