Individual provider Active NPI

Ian E Shuman, DDS

  • Dentist
  • Pasadena, MD
National Provider Identifier
1164534764
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10940 Issued in MD
Practice address
8028 Ritchie Hwy
Suite 306
Pasadena, MD 21122-1075
Phone
(410) 766-5104
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10940 MD Primary

Addresses

Primary practice location

8028 Ritchie Hwy
Suite 306
Pasadena, MD 21122-1075

Mailing address

8028 Ritchie Hwy
Suite 306
Pasadena, MD 21122-1075
Phone (410) 766-5104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20160404001003 MD Order and Referring Only - DentistPractitioner - Dentist 0042517245

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10940MDMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164534764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8028 RITCHIE HWY",
            "address_2": "SUITE 306",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211221075",
            "telephone_number": "410-766-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8028 RITCHIE HWY",
            "address_2": "SUITE 306",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211221075",
            "telephone_number": "410-766-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMAN",
        "first_name": "IAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "10940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, MD

Sources for this page

Verify at the official NPI Registry.