Dr Jonathan R Shadi, DDS is a
Oral & Maxillofacial Surgery based in Los Angeles, California. Dr Jonathan R Shadi is licensed to practice in California (license number 58812) and his current practice location is
12300 Wilshire Blvd, Ste 326, Los Angeles, California. He can be reached at his office (for appointments etc.) via phone at
(310) 954-9449.
NPI number for Dr Jonathan R Shadi is 1528294709 and his current mailing address is 12300 Wilshire Blvd, Ste 326, Los Angeles, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1528294709.
Healthcare Provider's Profile
| Full Name | Dr Jonathan R Shadi |
|---|
| Gender | Male |
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| Speciality | Oral & Maxillofacial Surgery |
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| Location | 12300 Wilshire Blvd, Los Angeles, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1528294709
- Provider Enumeration Date: 06/02/2009
- Last Update Date: 09/23/2024
Medical Identifiers
Medical identifiers for Dr Jonathan R Shadi such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1528294709 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 58812 (California) | Secondary |
| 204E00000X | Oral & Maxillofacial Surgery | 58812 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jonathan R Shadi is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Jonathan R Shadi, DDS
12300 Wilshire Blvd, Ste 326,
Los Angeles, CA 90025-1020
Ph: (310) 954-9449 | Dr Jonathan R Shadi, DDS
12300 Wilshire Blvd, Ste 326,
Los Angeles, CA 90025
Ph: (310) 954-9449 |
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