Brian Thomas Shaughnessy, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

056944 Issued in NY

Practice address

6532 Anthony Dr Ste C
Victor, NY 14564-1403

Phone

(585) 869-5314

Fax

(585) 869-5314

NPI assigned

May 24, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

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

Practice roles

Locations

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.

• Victor Endodontics, PLLC

  • Endodontics
  • Victor, NY
  • NPI 1891100681
  NPD Authorized official

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

{
    "created_epoch": "1211587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520812800000",
    "number": "1508024787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6532 ANTHONY DR STE C",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145641403",
            "telephone_number": "585-869-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6532 ANTHONY DR STE C",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145641403",
            "telephone_number": "585-869-5314",
            "fax_number": "585-869-5314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAUGHNESSY",
        "first_name": "BRIAN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-24",
        "last_updated": "2018-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019770",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "056944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "019770",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASSURANT",
            "identifier": "381908328",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary T Senf, RPH
• Neal R Senglaub, BC-HIS
• Serenity Walk Counseling Services, LCSW, PLLC
• Kimberly Shade, P.T.
• John J Sharza, MD
• Chloe Jo Shearing, MSOT
• Susan Lee Sheldon, R.D., M.S., L.AC.
• Theresa Marie Shirtz, MS OTR/L
• Patrick Ryan Shober, PT, DPT
• Kristie M Sholly, M.S.

• Endodontics in Victor, NY
• Providers in Victor, NY by specialty
• Endodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2018; 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.