Patrick Shannon, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN1855517 Issued in MA

Practice address

1692 Massachusetts Ave
Cambridge, MA 02138-1878

Phone

(617) 864-5444

NPI assigned

Jul 26, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Periodontal Specialists, PLLC

  • Periodontics
  • Franklin, MA
  • NPI 1346966215
  NPD Authorized official

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1184937682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1692 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1692 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381878",
            "telephone_number": "617-864-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-26",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "DN1855517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sahar Shahnazi
• Danielle Shaked, PHD
• Anatoly P Shalnov, M.D.
• Mohamed Shamseddine, PHARMD
• Colleen M Shannon, LICSW
• Weiru Shao, MD
• Debra Shapiro, MD
• Mark Shapiro, M.D.
• Stephanie L Shapiro, M.D.
• Tannaz Shapurian, DMD, MS

• Periodontics in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Periodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.