Benjamin Ryan Shimel, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

64389 Issued in CA

Practice address

111 Deerwood Rd Ste 130
San Ramon, CA 94583-2194

Phone

(925) 217-4884

NPI assigned

May 4, 2015

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

Locations

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.

• Chan M. Park, D.D.S., M.D., PC and Benjamin R. Shimel, D.D.S., PC a PA

  dba Sycamore Oral & Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • San Ramon, CA
  • NPI 1124660014
  NPD

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1023495637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DEERWOOD RD STE 130",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945832194",
            "telephone_number": "925-217-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DEERWOOD RD STE 130",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945832194",
            "telephone_number": "925-217-4884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "423 7th St",
            "address_2": "Unit 201",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946076541",
            "country_code": "US",
            "telephone_number": "707-853-4792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIMEL",
        "first_name": "BENJAMIN",
        "middle_name": "RYAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-04",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "64389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angie M Shen
• Adit Shenoi
• Horia Sheryar
• Tamara Shih, PT, MPT
• Soyeon Shim
• Rachel Jane Shimer-Lal, MOT, OTR/L
• Shining Pathways Counseling Group Inc
• Shiva Mohtasham DDS, Inc (Shine On Dental Group)
• Yshay Shlesinger, M.D.
• Sarbjeet Kaur Shokar, RN

• Oral and Maxillofacial Surgery (Dentist) in San Ramon, CA
• Providers in San Ramon, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.