NPIMap

Organization Active NPI

Gregory M. Shupik, D.M.D., P.a.

  • Periodontics
  • Cherry Hill, NJ
National Provider Identifier
1053538116
Registry record updated Oct 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
22DI00971800 Issued in NJ
Legal business name
GREGORY M. SHUPIK, D.M.D., P.A.
Practice address
1910 Marlton Pike E
Suite 2
Cherry Hill, NJ 08003-2123
Phone
(856) 428-4746
Fax
(856) 751-4975
NPI assigned
Apr 19, 2007
Last updated
Oct 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Gregory M. Shupik, D.M.D.NPI 1740322296
Title
Periodontist
Phone
(856) 428-4746

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 22DI00971800 NJ Primary

Addresses

Primary practice location

1910 Marlton Pike E
Suite 2
Cherry Hill, NJ 08003-2123

Mailing address

1910 Marlton Pike E
Suite 2
Cherry Hill, NJ 08003-2123
Phone (856) 428-4746

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318896000000",
    "number": "1053538116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 MARLTON PIKE E",
            "address_2": "SUITE 2",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032123",
            "telephone_number": "856-428-4746",
            "fax_number": "856-751-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 MARLTON PIKE E",
            "address_2": "SUITE 2",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032123",
            "telephone_number": "856-428-4746",
            "fax_number": "856-751-4975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY M. SHUPIK, D.M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2011-10-18",
        "status": "A",
        "authorized_official_last_name": "SHUPIK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PERIODONTIST",
        "authorized_official_telephone_number": "856-428-4746",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DI00971800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.