Shawn McKinley Allen, DDS
Individual provider Active NPI General Practice Dentistry · Rotterdam, NY
NPI 1104921865 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104921865
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 042173-1 (NY)
- Practice address
- 1402 Helderberg Ave
Rotterdam, NY 12306 - Phone
- (518) 355-3800
- Fax
- (518) 355-3363
- NPI assigned
- Sep 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181025002219 | NY | Order and Referring Only - Dentist |
1456604123 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042173-1 | NY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shawn Allen DDS, PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 042173-1 | NY | Yes |
Addresses
Primary practice location
1402 Helderberg Ave
Rotterdam, NY 12306
Mailing address
1402 Helderberg Ave
Rotterdam, NY 12306
Phone (518) 355-3800
Other providers in Rotterdam, NY
- Steven Beattie
- BJ'S Wholesale Club Inc.
- BJ'S Wholesale Club Inc.
- Capital Foot Specialists
- Valeria Crespo Cruz
All providers in Rotterdam, NY · General Practice Dentistry in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.