Active NPI
Susan a Sheets DDS a Professional Dental Corporation
- Orofacial Pain Dentistry
- El Segundo, CA
National Provider Identifier
1922488352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orofacial Pain Dentistry
- Legal business name
- SUSAN A SHEETS DDS A PROFESSIONAL DENTAL CORPORATION
- Practice address
- 131 W Grand Ave Ste B2
El Segundo, CA 90245-4243 - Phone
- (310) 832-2657
- NPI assigned
- Jun 1, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Ann Sheets, DDS
- Title
- Owner/Provider
- Phone
- (310) 525-0556
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | |||
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | |||
| Orofacial Pain Dentistry | 1223X2210X | Primary | ||
| Customized Equipment (DME) | 332BC3200X |
Addresses
Primary practice location
131 W Grand Ave Ste B2
El Segundo, CA 90245-4243
Mailing address
2515 S Western Ave Ste 109
San Pedro, CA 90732-4643
Phone (310) 832-2657
Other practice location 1
2515 S Western Ave
Ste 109
San Pedro, CA 90732-4643
Phone (310) 832-2657
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150916002991 | CA | DME Supplier - Oral Surgery - Dentist | 1456668805 | Practice locations: San Pedro, CA |
National Provider Directory
National Provider DirectoryLocations
131 W Grand Ave
Ste B2
El Segundo, CA 90245
Phone (310) 832-2657
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433116800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1780272000000",
"number": "1922488352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2515 S WESTERN AVE STE 109",
"city": "SAN PEDRO",
"state": "CA",
"postal_code": "907324643",
"telephone_number": "310-832-2657",
"fax_number": "310-832-5164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 W GRAND AVE STE B2",
"city": "EL SEGUNDO",
"state": "CA",
"postal_code": "902454243",
"telephone_number": "310-832-2657"
}
],
"practiceLocations": [
{
"address_1": "2515 S Western Ave",
"address_2": "Ste 109",
"address_purpose": "LOCATION",
"city": "San Pedro",
"state": "CA",
"postal_code": "907324643",
"country_code": "US",
"telephone_number": "310-832-2657",
"fax_number": "310-832-5164",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "SUSAN A SHEETS DDS A PROFESSIONAL DENTAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2015-06-01",
"last_updated": "2026-06-01",
"certification_date": "2026-06-01",
"status": "A",
"authorized_official_last_name": "SHEETS",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "ANN",
"authorized_official_title_or_position": "OWNER/PROVIDER",
"authorized_official_telephone_number": "310-525-0556",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223S0112X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223X2210X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Orofacial Pain",
"state": null,
"license": null,
"primary": true
},
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in El Segundo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.