Individual provider Active NPI

Peter L. Sheerin, D.M.D., INC.

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1821015769
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30250 Issued in CA
Practice address
1134 S Robertson Blvd
Suite 1
Los Angeles, CA 90035-1404
Phone
(310) 274-6089
Fax
(323) 272-3617
NPI assigned
Jul 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 30250 CA Primary

Addresses

Primary practice location

1134 S Robertson Blvd
Suite 1
Los Angeles, CA 90035-1404

Mailing address

1134 S Robertson Blvd
Suite 1
Los Angeles, CA 90035-1404
Phone (310) 274-6089

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30250CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821015769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 S ROBERTSON BLVD",
            "address_2": "SUITE 1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351404",
            "telephone_number": "310-274-6089",
            "fax_number": "323-272-3617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 S ROBERTSON BLVD",
            "address_2": "SUITE 1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351404",
            "telephone_number": "310-274-6089",
            "fax_number": "323-272-3617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEERIN",
        "first_name": "PETER",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.M.D., INC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "30250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • 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.