Justin F. Shyba, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

62533 Issued in CA

Practice address

2515 Porter St
Soquel, CA 95073-2463

Phone

(831) 462-8555

NPI assigned

Sep 3, 2013

Last updated

Sep 3, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Justin Shyba, D.D. S., Inc.

  dba Soquel Dental Office

  • General Practice Dentistry
  • Soquel, CA
  • NPI 1811168628
  NPD (past)

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

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378166400000",
    "number": "1992130454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 PORTER ST",
            "city": "SOQUEL",
            "state": "CA",
            "postal_code": "950732463",
            "telephone_number": "831-462-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 PORTER ST",
            "city": "SOQUEL",
            "state": "CA",
            "postal_code": "950732463",
            "telephone_number": "831-462-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHYBA",
        "first_name": "JUSTIN",
        "middle_name": "F.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-03",
        "last_updated": "2013-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mayra Lizeth Sanjuan, LA.C, DTCM
• Santa Cruz Community Counseling Center, Inc.
• Charles T Savoca, L.AC.
• Warren Alan Scott, M.D.
• Shannon Seeley, LCSW
• Kris L Sidman Gale, MA
• Silicon Valley TMS of Monterey Bay
• Thomas Robert Silverman, M.D.
• Gloria Jean Simpson, LCSW
• Jane Ellen Simpson, RN

• Dentist in Soquel, CA
• Providers in Soquel, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.