Chungling Shaaw, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48995 Issued in CA

Practice address

4055 Evergreen Village SQ Ste 240
San Jose, CA 95135-1750

Phone

(408) 223-9118

Fax

(408) 223-9228

NPI assigned

Mar 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801916945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 EVERGREEN VILLAGE SQ STE 240",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951351750",
            "telephone_number": "408-223-9118",
            "fax_number": "408-223-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 EVERGREEN VILLAGE SQ STE 240",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951351750",
            "telephone_number": "408-223-9118",
            "fax_number": "408-223-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAAW",
        "first_name": "CHUNGLING",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48995",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "51466",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Catherine Shaddy

• General Practice Dentistry in San Jose, CA
• Providers in San Jose, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.