NPIMap

Individual provider Active NPI

Yaser Shaheen, DMD

  • General Practice Dentistry
  • Berkley, MI
National Provider Identifier
1225419468
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901021613 Issued in MI
Practice address
3211 Coolidge High Way
#204
Berkley, MI 48072-2926
Phone
(313) 389-6518
NPI assigned
Jun 12, 2015
Last updated
May 24, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901021613 MI Primary

Addresses

Primary practice location

3211 Coolidge High Way
#204
Berkley, MI 48072-2926

Mailing address

27115 Northmore St
Dearborn Heights, MI 48127-3643
Phone (313) 918-5188

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

State licenses

LicenseStateTypeSpecialty
2901021613MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Yaser Shaheen D.M.D PLLC Current Accepting new patients
Summit RX LLC Current Accepting new patients

Organizations & group practices 9

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": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1225419468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27115 NORTHMORE ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273643",
            "telephone_number": "313-918-5188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 COOLIDGE HIGH WAY",
            "address_2": "#204",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480722926",
            "telephone_number": "313-389-6518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHEEN",
        "first_name": "YASER",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-12",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901021613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.