Active NPI
Shan Huey Yu, DDS MS
- Periodontics
- Baltimore, MD
National Provider Identifier
1184191132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 104
- Practice address
- 650 W Baltimore St
Baltimore, MD 21201-1510 - Phone
- (410) 706-7047
- NPI assigned
- Oct 29, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901021766 | MI | |
| Periodontics | 1223P0300X | 104 | MD | Primary |
Addresses
Primary practice location
650 W Baltimore St
Baltimore, MD 21201-1510
Mailing address
650 W Baltimore St Ste 5201
Baltimore, MD 21201-1510
Phone (410) 706-7047
Other practice location 1
1011 N University Ave
Ann Arbor, MI 48109-1078
Phone (734) 764-9185
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901021766 | MI | MD | General Practice Dentistry |
| 104 | MD | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725494400000",
"number": "1184191132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 W BALTIMORE ST STE 5201",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212011510",
"telephone_number": "410-706-7047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 W BALTIMORE ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212011510",
"telephone_number": "410-706-7047"
}
],
"practiceLocations": [
{
"address_1": "1011 N University Ave",
"address_purpose": "LOCATION",
"city": "Ann Arbor",
"state": "MI",
"postal_code": "481091078",
"country_code": "US",
"telephone_number": "734-764-9185",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YU",
"first_name": "SHAN HUEY",
"credential": "DDS MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-29",
"last_updated": "2024-09-05",
"certification_date": "2024-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901021766",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MD",
"license": "104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.