Active NPI
Andrew Beihong Shi, DDS
- Dentist
- Lake Forest, CA
National Provider Identifier
1902006836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 55838
- Practice address
- 22421 El Toro Rd
Suite E
Lake Forest, CA 92630-5049 - Phone
- (949) 770-4707
- Fax
- (949) 770-4708
- NPI assigned
- Jul 19, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 55838 | CA | Primary |
Addresses
Primary practice location
22421 El Toro Rd
Suite E
Lake Forest, CA 92630-5049
Mailing address
2 Cartier Aisle
Irvine, CA 92620-5708
Phone (415) 503-7584
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D55838 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 55838 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370217600000",
"number": "1902006836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 CARTIER AISLE",
"city": "IRVINE",
"state": "CA",
"postal_code": "926205708",
"telephone_number": "415-503-7584",
"fax_number": "949-770-4707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22421 EL TORO RD",
"address_2": "SUITE E",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "926305049",
"telephone_number": "949-770-4707",
"fax_number": "949-770-4708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHI",
"first_name": "ANDREW",
"middle_name": "BEIHONG",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-19",
"last_updated": "2013-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "55838",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D55838",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Forest, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.