Matthew Bernard Shaughnessy, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.24891 Issued in OH

Practice address

2962 State Route 39
Millersburg, OH 44654-8852

Phone

(330) 893-3363

NPI assigned

Jun 18, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Scott Kalniz Dental Partners II Professional Corporation

  • Dental Clinic/Center
  • Millersburg, OH
  • NPI 1295237444
  NPD (past)
• Edp of Illinois P.C

  • Dental Clinic/Center
  • Dupo, IL
  • NPI 1154712784
  NPD (past)
• Walter D. Flor, D.D.S., LTD.

  • Dental Clinic/Center
  • Homewood, IL
  • NPI 1558668756
  NPD (past)

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1235510967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 BEECHWOOD DR",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441412647",
            "telephone_number": "708-362-2594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2962 STATE ROUTE 39",
            "city": "MILLERSBURG",
            "state": "OH",
            "postal_code": "446548852",
            "telephone_number": "330-893-3363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18340 Governors Hwy",
            "address_purpose": "LOCATION",
            "city": "Homewood",
            "state": "IL",
            "postal_code": "604302910",
            "country_code": "US",
            "telephone_number": "708-799-0660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAUGHNESSY",
        "first_name": "MATTHEW",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-18",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.033443",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.24891",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avi Schiowitz, DO
• Eric W Schmidt, DC
• Scott Kalniz Dental Partners II Professional Corporation
• Robert Russell Sears, O.D.
• Michele G Settle, LPN
• Ibrahim Sozen, MD
• Jordan Mitchell Chase Spector
• Renee Lynette Spencer, R.D./L.D.
• Rachel Steiner, M.A. CFY-SLP
• Tonya Stone

• All providers in Millersburg, OH
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.