Individual provider Active NPI

Sweety Dayanand Shah, DMD, MS

  • Prosthodontics
  • Fort Mill, SC
National Provider Identifier
1154971042
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
11615 Issued in NC
Practice address
481 Munn Rd Ste 100
Fort Mill, SC 29715-0014
Phone
(828) 254-1944
NPI assigned
Sep 12, 2019
Last updated
Feb 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 11615 NC Primary

Addresses

Primary practice location

481 Munn Rd Ste 100
Fort Mill, SC 29715-0014

Mailing address

481 Munn Rd Ste 100
Fort Mill, SC 29715-0014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20230615001972 SC Order and Referring Only - DentistPractitioner - Dentist 1951769405

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6795SCMDProfessional Counselor
11615NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Phillips & Schmitt, DDS PA PastSince Sep 1, 2019 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1154971042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 MUNN RD STE 100",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297150014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 MUNN RD STE 100",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297150014",
            "telephone_number": "828-254-1944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SWEETY",
        "middle_name": "DAYANAND",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-12",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NC",
            "license": "11615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

Verify at the official NPI Registry.