Shadi Rad, DDS, a Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

51991 Issued in CA

Legal business name

SHADI RAD, DDS, A DENTAL CORPORATION

Doing business as

Gateway Dental Group

Practice address

24000 Alicia Pkwy
Suite 34
Mission Viejo, CA 92691-3929

Phone

(949) 707-7000

Fax

(949) 707-0088

NPI assigned

Apr 22, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Shadi M Rad Jadali, DDS, MS

Title

President

Phone

(949) 707-7000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gateway Dental Group Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ahmad Rokni, DMD

  • Prosthodontics
  • Mission Viejo, CA
  • NPI 1710284690
  NPD (past)

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398124800000",
    "number": "1932529690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24000 ALICIA PKWY",
            "address_2": "SUITE 34",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926913929",
            "telephone_number": "949-707-7000",
            "fax_number": "949-707-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24000 ALICIA PKWY",
            "address_2": "SUITE 34",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926913929",
            "telephone_number": "949-707-7000",
            "fax_number": "949-707-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADI RAD, DDS, A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-22",
        "last_updated": "2014-04-22",
        "status": "A",
        "authorized_official_last_name": "RAD JADALI",
        "authorized_official_first_name": "SHADI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-707-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "51991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1770665291",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrew Michael Sevillano
• Seyed H. Shahrokni, MD, Inc.
• Sgbrc LLC (San Giovanni Residential Care)
• Ahmad Shaban, MD
• Ronald Conway Shackelford, D.MIN., M.S., MFT
• Shahrzad Shadmani, NP
• Laura Louise Shaffer, R.N.
• Katayoun Shahidi, LVN
• Sahar Shahidi, PHYSICAL THERAPIST
• Shahram Javaheri, MD, Inc.

• General Practice Dentistry in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; 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.