Individual provider Active NPI

Jason Shoe, DMD MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Hanover, PA
National Provider Identifier
1497020275
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DS037178 Issued in PA
Practice address
141 Wilson Ave
Suite E
Hanover, PA 17331-1469
Phone
(717) 634-2461
NPI assigned
Mar 13, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DS037178 PA Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 14277 MD

Addresses

Primary practice location

141 Wilson Ave
Suite E
Hanover, PA 17331-1469

Mailing address

141 Wilson Ave
Suite E
Hanover, PA 17331-1469
Phone (717) 634-2461

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
14277MDMDOrthodontics and Dentofacial Orthopedic Dentist
DS037178PAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sculpture32 Orthodontics, LLC Orthodontics and Dentofacial Orthopedics Current Accepting new patients
F&S Smiles, LLC Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331596800000",
    "number": "1497020275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 WILSON AVE",
            "address_2": "SUITE E",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173311469",
            "telephone_number": "717-634-2461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 WILSON AVE",
            "address_2": "SUITE E",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173311469",
            "telephone_number": "717-634-2461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOE",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "DMD MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-13",
        "last_updated": "2012-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PA",
            "license": "DS037178",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MD",
            "license": "14277",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; 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.