NPIMap

Organization Active NPI

Shayna Rondon DDS Inc

Doing business as Periodontal Associates

  • Periodontics
  • Livermore, CA
National Provider Identifier
1942608773
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
59292 Issued in CA
Legal business name
SHAYNA RONDON DDS INC
Doing business as
Periodontal Associates
Practice address
1171 Murrieta Blvd
Suite 200
Livermore, CA 94550-4143
Phone
(925) 449-6633
Fax
(925) 449-0766
NPI assigned
Dec 10, 2014
Last updated
Dec 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Authorized official

Name
Dr. Shayna Rondon, DDS MSNPI 1669736690
Title
President
Phone
(925) 449-6633

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 59292 CA Primary

Addresses

Primary practice location

1171 Murrieta Blvd
Suite 200
Livermore, CA 94550-4143

Mailing address

1171 Murrieta Blvd
Suite 200
Livermore, CA 94550-4143
Phone (925) 449-6633

Other names 1

  • Periodontal Associates Doing business as

National Provider Directory

National Provider Directory

Locations

1171 Murrieta Blvd
Ste 200
Livermore, CA 94550
Phone (925) 449-6633

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1418169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418169600000",
    "number": "1942608773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 MURRIETA BLVD",
            "address_2": "SUITE 200",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945504143",
            "telephone_number": "925-449-6633",
            "fax_number": "925-449-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 MURRIETA BLVD",
            "address_2": "SUITE 200",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945504143",
            "telephone_number": "925-449-6633",
            "fax_number": "925-449-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAYNA RONDON DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-10",
        "last_updated": "2014-12-10",
        "status": "A",
        "authorized_official_last_name": "RONDON",
        "authorized_official_first_name": "SHAYNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-449-6633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "59292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Periodontal Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Livermore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.