NPIMap

Organization Active NPI

Susan Shada RDH, LLC

  • Dental Hygienist
  • Thornton, CO
National Provider Identifier
1598906125
Registry record updated Mar 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
903675 Issued in CO
Legal business name
SUSAN SHADA RDH, LLC
Practice address
9197 Grant St
Thornton, CO 80229-4361
Phone
(303) 358-6092
NPI assigned
Mar 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2009

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

Authorized official

Name
Ms. Susan Marie Shada, RDHNPI 1629214291
Title
Owner
Phone
(303) 358-6092

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental HygienistGroup: 193400000X SINGLE SPECIALTY GROUP 124Q00000X 903675 CO Primary

Addresses

Primary practice location

9197 Grant St
Thornton, CO 80229-4361

Mailing address

11470 Paris St
Henderson, CO 80640-7614
Phone (303) 358-6092

National Provider Directory

National Provider Directory

Locations

9197 Grant St
Thornton, CO 80229
Phone (303) 358-6092

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1236729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236729600000",
    "number": "1598906125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11470 PARIS ST",
            "city": "HENDERSON",
            "state": "CO",
            "postal_code": "806407614",
            "telephone_number": "303-358-6092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9197 GRANT ST",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294361",
            "telephone_number": "303-358-6092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN SHADA RDH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-11",
        "last_updated": "2009-03-11",
        "status": "A",
        "authorized_official_last_name": "SHADA",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-358-6092",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "903675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2009; 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.