Individual provider Active NPI

Andriana Shumova, DMD

  • General Practice Dentistry
  • Rochester, NY
National Provider Identifier
1225437841
Registry record updated Jun 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
058460 Issued in NY
Practice address
1655 Elmwood Ave Ste 215
Rochester, NY 14620-3426
Phone
(585) 442-1900
NPI assigned
Aug 19, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 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 058460 NY Primary

Addresses

Primary practice location

1655 Elmwood Ave Ste 215
Rochester, NY 14620-3426

Mailing address

1655 Elmwood Ave Ste 215
Rochester, NY 14620-3426
Phone (585) 442-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160829003058 NY Order and Referring Only - DentistPractitioner - Dentist 9739474743

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
058460NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
E a Torrado DDS P C General Practice Past Accepting new patients

Organizations & group practices 1

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": "1408406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1225437841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 ELMWOOD AVE STE 215",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146203426",
            "telephone_number": "585-442-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 ELMWOOD AVE STE 215",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146203426",
            "telephone_number": "585-442-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMOVA",
        "first_name": "ANDRIANA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-19",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "058460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.