Provider Demographics
NPI:1386950954
Name:SHAW, JAMES CHUNG (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CHUNG
Last Name:SHAW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8221 ROCHESTER AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-0721
Mailing Address - Country:US
Mailing Address - Phone:310-347-6172
Mailing Address - Fax:310-265-8038
Practice Address - Street 1:8221 ROCHESTER AVE STE 110
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-0721
Practice Address - Country:US
Practice Address - Phone:310-347-6172
Practice Address - Fax:310-265-8038
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59455122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist