Active NPI
Jennifer Shaw, D.D.S.
- Dentist
- Mukilteo, WA
National Provider Identifier
1619193778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019025522
- Practice address
- 11700 Mukilteo Speedway
#502
Mukilteo, WA 98275-5432 - Phone
- (425) 290-5573
- NPI assigned
- Apr 17, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 019025522 | IL | Primary |
Addresses
Primary practice location
11700 Mukilteo Speedway
#502
Mukilteo, WA 98275-5432
Mailing address
11700 Mukilteo Speedway
Mukilteo, WA 98275-5432
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019025522 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Huang DDS PLLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409788800000",
"number": "1619193778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11700 MUKILTEO SPEEDWAY",
"city": "MUKILTEO",
"state": "WA",
"postal_code": "982755432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11700 MUKILTEO SPEEDWAY",
"address_2": "#502",
"city": "MUKILTEO",
"state": "WA",
"postal_code": "982755432",
"telephone_number": "425-290-5573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-17",
"last_updated": "2014-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019025522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mukilteo, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.