Provider Demographics
NPI:1659352524
Name:SHAW, MICHAEL SHIANGSU (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SHIANGSU
Last Name:SHAW
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Gender:M
Credentials:DDS, MSD
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Mailing Address - Street 1:14150 CULVER DR
Mailing Address - Street 2:#303
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-0323
Mailing Address - Country:US
Mailing Address - Phone:949-551-1013
Mailing Address - Fax:949-551-8023
Practice Address - Street 1:14150 CULVER DR
Practice Address - Street 2:#303
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-0315
Practice Address - Country:US
Practice Address - Phone:949-551-1013
Practice Address - Fax:949-551-8023
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA361131223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics