Organization Active NPI

Susan a Sheets DDS a Professional Dental Corporation

  • Orofacial Pain Dentistry
  • El Segundo, CA
National Provider Identifier
1922488352
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orofacial Pain DentistryTaxonomy code 1223X2210X
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

Updated by the provider on Jun 1, 2026

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

Authorized official

Name
Susan Ann Sheets, DDSNPI 1730193517
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)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X
Orofacial Pain DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 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 IDStateProvider typePAC IDDetails
O20150916002991 CA DME Supplier - Oral Surgery - Dentist 1456668805 Practice locations: San Pedro, CA

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.