Katherine Jie Shi

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

106060 Issued in CA

Practice address

1810 Professional Dr Ste a
Sacramento, CA 95825-2165

Phone

(916) 485-6900

NPI assigned

Apr 30, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

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.

• DRS. Whitnack, Keating, Greene & Bal, a Dental Corporation

  • Endodontics
  • Sacramento, CA
  • NPI 1316129935
  NPD (past)

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1295399756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3907 SAN CARLOS WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958202709",
            "telephone_number": "678-507-4824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 PROFESSIONAL DR STE A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252165",
            "telephone_number": "916-485-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHI",
        "first_name": "KATHERINE",
        "middle_name": "JIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-30",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "106060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mursal Shetab, RN
• Mariya Shevchenko
• Ivan Shevchyk
• Kris Shevlin, P.T.
• Aaron David Shewmaker
• Lucy Shi
• Ruixin Shi, PHARMD
• Gayle Kimi Shibata, PPS
• Ryan Shickman, PSYD
• Kie Shidara

• Endodontics in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.