Active NPI
Nushin Shir, D.D.S.
- Dentist
- Los Angeles, CA
National Provider Identifier
1902086895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 41042
- Practice address
- 12021 Wilshire Blvd # 456
Los Angeles, CA 90025-1206 - Phone
- (310) 866-0430
- Fax
- (310) 826-1894
- NPI assigned
- Nov 7, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 41042 | CA | Primary |
Addresses
Primary practice location
12021 Wilshire Blvd # 456
Los Angeles, CA 90025-1206
Mailing address
12021 Wilshire Blvd # 456
Los Angeles, CA 90025-1206
Phone (310) 866-0430
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41042 | Other | CA | DENTAL BOARD OF CALIFORNI |
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 |
|---|---|---|---|
| 41042 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424044800000",
"number": "1902086895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12021 WILSHIRE BLVD # 456",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900251206",
"telephone_number": "310-866-0430",
"fax_number": "310-826-1894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12021 WILSHIRE BLVD # 456",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900251206",
"telephone_number": "310-866-0430",
"fax_number": "310-826-1894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIR",
"first_name": "NUSHIN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-07",
"last_updated": "2015-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "41042",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL BOARD OF CALIFORNI",
"identifier": "41042",
"state": "CA"
}
],
"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 Feb 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.