Nastassia Elena Shields, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN21816 Issued in FL

Practice address

7319 W Colonial Dr
Orlando, FL 32818-6746

Phone

(407) 294-9200

NPI assigned

Jul 6, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1093198301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7319 W COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328186746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7319 W COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328186746",
            "telephone_number": "407-294-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "NASTASSIA",
        "middle_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-06",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "058481",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN21816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renae Shibata, MD
• Tracy Shibla, APRN
• Whitney Brooke Shidler, CNM
• Shield of Colors LLC
• Ella Dawn Marie Shields
• Lauren Elizabeth Shifflett, FNP-BC
• Jacqueline Danielle Shiftlett, PTA
• Alexandra Leigh Shigo, PA-C
• Chandler James Shiley, PT, DPT
• Ronald Shill, M.D.

• General Practice Dentistry in Orlando, FL
• Providers in Orlando, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.