Priya Devi Shaffer, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D13091 Issued in MN

Practice address

6041 Main St # 40
North Branch, MN 55056-6588

Phone

(651) 674-4811

NPI assigned

Apr 19, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395014400000",
    "number": "1386901007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6041 MAIN ST # 40",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550566588",
            "telephone_number": "651-674-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6041 MAIN ST # 40",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550566588",
            "telephone_number": "651-674-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "PRIYA",
        "middle_name": "DEVI",
        "name_prefix": "Miss",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-19",
        "last_updated": "2014-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D4437",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Johnson Rehder, MD
• Richard R. Nyman, D.D.S., P.a.
• Kristen Elise Ross, PHARMD
• Sage Spine Pain and Nerve Center
• Amanda Sawyer, L.AC.
• Shawn T McCullough DDS, PLLC
• Shift Solutions
• Shopko Stores Operating Co LLC
• Shopko Stores Operating Co LLC
• Erica Sierra

• Dentist in North Branch, MN
• Providers in North Branch, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; 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.