Active NPI
Stewart Dana Shernan, DMD, BS
- Dentist
- Malden, MA
National Provider Identifier
1144405192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 16705
- Practice address
- 578 Main St
Malden, MA 02148-3900 - Phone
- (781) 324-6100
- Fax
- (781) 321-3544
- NPI assigned
- Jan 8, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 16705 | MA | Primary |
Addresses
Primary practice location
578 Main St
Malden, MA 02148-3900
Mailing address
578 Main St
Malden, MA 02148-3900
Phone (781) 324-6100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16705 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199750400000",
"number": "1144405192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "578 MAIN ST",
"city": "MALDEN",
"state": "MA",
"postal_code": "021483900",
"telephone_number": "781-324-6100",
"fax_number": "781-321-3544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "578 MAIN ST",
"city": "MALDEN",
"state": "MA",
"postal_code": "021483900",
"telephone_number": "781-324-6100",
"fax_number": "781-321-3544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERNAN",
"first_name": "STEWART",
"middle_name": "DANA",
"name_prefix": "Dr.",
"credential": "DMD, BS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-08",
"last_updated": "2008-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "16705",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malden, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.