Individual provider Active NPI

Kristen Shen

  • Student in an Organized Health Care Education/Training Program
  • Las Vegas, NV
National Provider Identifier
1316737927
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1001 Shadow LN
Las Vegas, NV 89106-4124
Phone
(702) 774-5134
NPI assigned
May 7, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X RES-30747 IA
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1001 Shadow LN
Las Vegas, NV 89106-4124

Mailing address

801 Newton Rd
Iowa City, IA 52242-8004

Other practice location 1

801 Newton Rd
Iowa City, IA 52242-8004
Phone (319) 335-7499

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

NPI Registry JSON

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

{
    "created_epoch": "1746576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1316737927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 NEWTON RD",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522428004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 SHADOW LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064124",
            "telephone_number": "702-774-5134"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Newton Rd",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522428004",
            "country_code": "US",
            "telephone_number": "319-335-7499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEN",
        "first_name": "KRISTEN",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-05-07",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IA",
            "license": "RES-30747",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; 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.