John L Shi, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

048485 Issued in NY

Practice address

139 Centre St Ste 306
New York, NY 10013-4554

Phone

(212) 925-7066

Fax

(212) 925-7066

NPI assigned

Apr 22, 2007

Sex

Male

Sole proprietor

Yes

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• John Shi DDS PC

  • Clinic/Center
  • New York, NY
  • NPI 1316327760
  NPD (past) Authorized official

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

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712448000000",
    "number": "1104044791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 CENTRE ST STE 306",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134554",
            "telephone_number": "212-925-7066",
            "fax_number": "212-925-7066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 CENTRE ST STE 306",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134554",
            "telephone_number": "212-925-7066",
            "fax_number": "212-925-7066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHI",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-22",
        "last_updated": "2024-04-07",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "048485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haoyuan Shi, EDM, MA
• Helen Shi
• Jay Shi
• Jenny Shi, PA-C
• Jenny Zhiyun Shi, OD
• Kelly Shi
• Lin Shi
• Linjia Shi, DDS
• Lynn Shi, MD
• Margaret Shi, LMHC, MA

• Dentist in New York, NY
• Providers in New York, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2024; 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.