Individual provider Active NPI

Shahin Vohara

  • General Practice Dentistry
  • Baltimore, MD
National Provider Identifier
1477051779
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16302 Issued in MD
Practice address
Dental Dreams , 4510 Edmondson Avenue
Edmondson Village Shopping Center
Baltimore, MD 21229
Phone
(410) 233-5777
NPI assigned
Feb 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401415901 VA
General Practice Dentistry 1223G0001X 16302 MD Primary

Addresses

Primary practice location

Dental Dreams , 4510 Edmondson Avenue
Edmondson Village Shopping Center
Baltimore, MD 21229

Mailing address

350 N Clark Street
Suite 600 C/0 Kos Services, Attn: HR
Chicago, IL 60654-4782

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20180515001974 MD Order and Referring Only - DentistPractitioner - Dentist 2264796473

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401415901VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1477051779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N CLARK STREET",
            "address_2": "SUITE 600 C/0 KOS SERVICES, ATTN: HR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DENTAL DREAMS , 4510 EDMONDSON AVENUE",
            "address_2": "EDMONDSON VILLAGE SHOPPING CENTER",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21229",
            "telephone_number": "410-233-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOHARA",
        "first_name": "SHAHIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-01",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415901",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "16302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.