Individual provider Active NPI

Minhuai Shi, D.D.S.

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1063648863
Registry record updated Mar 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
056238 Issued in NY
Practice address
816 59TH St
Brooklyn, NY 11220-3783
Phone
(347) 205-0616
NPI assigned
Jun 8, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 056238 NY Primary

Addresses

Primary practice location

816 59TH St
Brooklyn, NY 11220-3783

Mailing address

6708 152ND St
Suite 266a
Flushing, NY 11367-1430
Phone (347) 205-0616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160509001968 NY Order and Referring Only - General PracticePractitioner - General Practice 7810296191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427068800000",
    "number": "1063648863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6708 152ND ST",
            "address_2": "SUITE 266A",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671430",
            "telephone_number": "347-205-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 59TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203783",
            "telephone_number": "347-205-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHI",
        "first_name": "MINHUAI",
        "name_prefix": "Mr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-08",
        "last_updated": "2015-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "056238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.