Active NPI
Shakila Banu Usman, D.D.S
- Dentist
- Gaithersburg, MD
National Provider Identifier
1508854985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 13107
- Practice address
- 108 Olde Towne Ave
Suite 8
Gaithersburg, MD 20877-2095 - Phone
- (301) 519-8887
- Fax
- (301) 519-2706
- NPI assigned
- Oct 11, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 13107 | MD | Primary |
Addresses
Primary practice location
108 Olde Towne Ave
Suite 8
Gaithersburg, MD 20877-2095
Mailing address
17125 Flatwood Dr
Rockville, MD 20855-2539
Phone (301) 963-8284
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160113000134 | MD | Order and Referring Only - Oral Surgery | 2264734953 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13107 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508854985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17125 FLATWOOD DR",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208552539",
"telephone_number": "301-963-8284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 OLDE TOWNE AVE",
"address_2": "SUITE 8",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208772095",
"telephone_number": "301-519-8887",
"fax_number": "301-519-2706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "USMAN",
"first_name": "SHAKILA",
"middle_name": "BANU",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-10-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "13107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.