Individual provider Active NPI

Julia Shneyderman, DMD

  • Dentist
  • Cleveland, OH
National Provider Identifier
1215422001
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
004018 Issued in OH
Practice address
11202 Shaker Blvd Ste 136
Cleveland, OH 44104
Phone
(216) 368-7238
NPI assigned
Jun 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 004018 OH Primary

Addresses

Primary practice location

11202 Shaker Blvd Ste 136
Cleveland, OH 44104

Mailing address

4444 Habersham LN S
Richmond Heights, OH 44143-2631
Phone (216) 978-5864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20190725000995 OH Practitioner - Oral SurgeryPractitioner - Dentist 2668708827 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004018OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lorain County Health & Dentistry Current Accepting new patients
Lorain County Health & Dentistry CurrentSince Jul 11, 2019 Accepting new patients
Lorain County Health & Dentistry CurrentSince Jul 11, 2019 Accepting new patients

Locations

105 Louden Ct
Elyria, OH 44035

1205 Broadway
Lorain, OH 44052

260 S Main St
Oberlin, OH 44074

Interoperability endpoints

  • Direct secure messaging: julia.shneyderman.p11@direct.loraincountyhealth.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1215422001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 HABERSHAM LN S",
            "city": "RICHMOND HEIGHTS",
            "state": "OH",
            "postal_code": "441432631",
            "telephone_number": "216-978-5864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11202 SHAKER BLVD STE 136",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44104",
            "telephone_number": "216-368-7238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHNEYDERMAN",
        "first_name": "JULIA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "004018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.