Individual provider Active NPI

Sandra Shih, DDS

  • Pediatric Dentistry
  • White Marsh, MD
National Provider Identifier
1295881597
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
13125 Issued in MD
Practice address
5430 Campbell Blvd
Suite 209
White Marsh, MD 21162
Phone
(443) 725-4185
Fax
(443) 725-4187
NPI assigned
Jan 27, 2007
Last updated
Oct 23, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 13125 MD Primary

Addresses

Primary practice location

5430 Campbell Blvd
Suite 209
White Marsh, MD 21162

Mailing address

5430 Campbell Blvd
Suite 209
White Marsh, MD 21162-5500
Phone (443) 725-4185

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
13125MDMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
White Marsh Pediatric Dentistry, LLC Pediatric Dentistry CurrentSince Mar 24, 2024 Accepting new patients

Locations

5430 Campbell Blvd
Ste 209
White Marsh, MD 21162
Phone (443) 725-4185

Interoperability endpoints

  • Direct secure messaging: sshih1373@direct.umm.edu

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, 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": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1295881597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5430 CAMPBELL BLVD",
            "address_2": "SUITE 209",
            "city": "WHITE MARSH",
            "state": "MD",
            "postal_code": "211625500",
            "telephone_number": "443-725-4185",
            "fax_number": "443-725-4187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 CAMPBELL BLVD",
            "address_2": "SUITE 209",
            "city": "WHITE MARSH",
            "state": "MD",
            "postal_code": "21162",
            "telephone_number": "443-725-4185",
            "fax_number": "443-725-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIH",
        "first_name": "SANDRA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-27",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "13125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Marsh, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; 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.