Individual provider Active NPI

Diana E Shoe, DDS

  • General Practice Dentistry
  • Hanover, PA
National Provider Identifier
1275979114
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS039236 Issued in PA
Practice address
335 Broadway
Hanover, PA 17331-2505
Phone
(717) 634-2461
NPI assigned
May 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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 DS039236 PA Primary

Addresses

Primary practice location

335 Broadway
Hanover, PA 17331-2505

Mailing address

1750 Youngs Rd
Hanover, PA 17331-9451
Phone (443) 257-7014

Other practice location 1

326 E King St
Littlestown, PA 17340-1618
Phone (717) 359-4101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150505000653 PA Order and Referring Only - DentistPractitioner - Dentist 9537488093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS039236PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Family Smiles LLC CurrentSince Mar 21, 2021 Accepting new patients
Facial 32 LLC CurrentSince Sep 23, 2021 Accepting new patients
F&S Smiles, LLC Past Accepting new patients

Locations

335 Broadway
Hanover, PA 17331
Phone (717) 632-2565

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": "1368921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1275979114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 YOUNGS RD",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173319451",
            "telephone_number": "443-257-7014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 BROADWAY",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173312505",
            "telephone_number": "717-634-2461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "326 E King St",
            "address_purpose": "LOCATION",
            "city": "Littlestown",
            "state": "PA",
            "postal_code": "173401618",
            "country_code": "US",
            "telephone_number": "717-359-4101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOE",
        "first_name": "DIANA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-19",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS039236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, PA

Sources for this page

Verify at the official NPI Registry.