Individual provider Active NPI

Owais Shaikh, DDS

  • General Practice Dentistry
  • Corona, CA
National Provider Identifier
1811412059
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
105659 Issued in CA
Practice address
131 W Ontario Ave Ste 102
Corona, CA 92882-5274
Phone
(951) 898-9700
NPI assigned
Aug 9, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1857720 MA
General Practice Dentistry 1223G0001X 105659 CA Primary

Addresses

Primary practice location

131 W Ontario Ave Ste 102
Corona, CA 92882-5274

Mailing address

131 W Ontario Ave Ste 102
Corona, CA 92882-5274
Phone (951) 898-9700

Other practice location 1

11 Bay State Ct
Brewster, MA 02631-2120
Phone (508) 255-0111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210520002304 CA Order and Referring Only - DentistPractitioner - Dentist 7618376864

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1857720MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
CF Rodgers DDS Inc General Practice PastSince Apr 6, 2021 Accepting new patients
Charles F Rodgers Dental Corporation General Practice PastSince Apr 6, 2021 Accepting new patients
Massachusetts Dental Professionals, P.C. Dentist Past Accepting new patients
South Shore Mental Health Center, Inc. Past Accepting new patients

Organizations & group practices 4

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": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1811412059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 W ONTARIO AVE STE 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928825274",
            "telephone_number": "951-898-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 W ONTARIO AVE STE 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928825274",
            "telephone_number": "951-898-9700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Bay State Ct",
            "address_purpose": "LOCATION",
            "city": "Brewster",
            "state": "MA",
            "postal_code": "026312120",
            "country_code": "US",
            "telephone_number": "508-255-0111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAIKH",
        "first_name": "OWAIS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-09",
        "last_updated": "2022-07-21",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1857720",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "105659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.