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DR. JONATHAN R. SHADI D.D.S.
NPI 1528294709
Oral & Maxillofacial Surgery in Los Angeles, CA

Active since June 02, 2009PECOS Enrolled
12300 WILSHIRE BLVD, STE 326, LOS ANGELES, CA 90025(310) 954-9449(310) 954-9470 Get Directions Write a Review

NPPES record last updated: September 23, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 23, 2024, May 30, 2019, Feb 16, 2018 (3 updates tracked since 2018).

About Dr. Jonathan R. Shadi D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JONATHAN R. SHADI D.D.S. (NPI 1528294709) is an individual oral & maxillofacial surgery provider in Los Angeles, California, licensed in California (58812) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1528294709
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameDR. JONATHAN R. SHADICredential: D.D.S.
Location Address12300 WILSHIRE BLVD, STE 326Los Angeles, CA 90025
Mailing Address12300 Wilshire Blvd, Ste 326Los Angeles, CA 90025-1020 · (310) 954-9449 · Fax (310) 954-9470
Phone(310) 954-9449
Fax(310) 954-9470
Sole ProprietorNo
Enumeration DateJune 2, 2009
Last NPPES UpdateSeptember 23, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 23, 2024
✔ NPI 1528294709 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in CA · 58812
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License 58812 (CA)
12300 WILSHIRE BLVD, Los Angeles, CA 90025
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jonathan R. Shadi D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOSEPH MICHAEL SMURDA
Psychiatry & Neurology (Psychiatry)
12300 WILSHIRE BLVD, SUITE 330
LOS ANGELES, CA 90025
Los Angeles County (310) 820-3333
WILSHIRE ORAL SURGERY & IMPLANT CENTER
Dentist (Oral and Maxillofacial Surgery)
12300 WILSHIRE BLVD, SUITE #326
LOS ANGELES, CA 90025
Los Angeles County (310) 652-6553
LINDA MOGHTADER M.D.
Psychiatry & Neurology (Psychosomatic Medicine)
12300 WILSHIRE BLVD, SUITE 330
LOS ANGELES, CA 90025
Los Angeles County (310) 442-7601
DR. HARVEY ALLEN STERNBACH MD
Psychiatry & Neurology (Psychiatry)
12300 WILSHIRE BLVD, #330
LOS ANGELES, CA 90025
Los Angeles County (310) 979-7774
DR. RONALD ALAN GERSHMAN M.D.
Psychiatry & Neurology (Addiction Psychiatry)
12300 WILSHIRE BLVD, SUITE 310
LOS ANGELES, CA 90025
Los Angeles County (310) 207-7166
ZIVA DOSHI LCSW, OSW-C
Social Worker (Clinical)
12300 WILSHIRE BLVD
LOS ANGELES, CA 90025
Los Angeles County (424) 625-8783

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Shadi's NPI number?

The NPI number for Jonathan Shadi is 1528294709. It was assigned to this individual provider in the NPPES registry on June 2, 2009.

Where is Jonathan Shadi located?

Jonathan Shadi practices at 12300 Wilshire Blvd Ste 326, Los Angeles, CA 90025. The listed phone number is (310) 954-9449.

What is Jonathan Shadi's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Jonathan Shadi enrolled in Medicare?

Yes. Jonathan Shadi is registered in the Medicare PECOS enrollment system.

What insurance does Jonathan Shadi accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 7 other insurers list Jonathan Shadi as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jonathan Shadi was last updated on September 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.