Active NPI
Avraham Y Shainhouse, DDS
- Periodontics
- Belmont, MA
National Provider Identifier
1649326760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DN21767
- Practice address
- 250 Trapelo Rd
Belmont, MA 02478-1849 - Phone
- (617) 489-1900
- NPI assigned
- Jan 25, 2007
- Last updated
- Feb 9, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 021767 | MA | |
| Periodontics | 1223P0300X | DN21767 | MA | Primary |
Addresses
Primary practice location
250 Trapelo Rd
Belmont, MA 02478-1849
Mailing address
250 Trapelo Rd
Belmont, MA 02478-1849
Phone (617) 489-1900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0206920 | Medicaid | MA | |
| 9756892 | Medicaid | MA |
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 |
|---|---|---|---|
| 021767 | MA | MD | General Practice Dentistry |
| DN21767 | MA | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 42 North Dental Care, LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328745600000",
"number": "1649326760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 TRAPELO RD",
"city": "BELMONT",
"state": "MA",
"postal_code": "024781849",
"telephone_number": "617-489-1900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 TRAPELO RD",
"city": "BELMONT",
"state": "MA",
"postal_code": "024781849",
"telephone_number": "617-489-1900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAINHOUSE",
"first_name": "AVRAHAM",
"middle_name": "Y",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2012-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "021767",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MA",
"license": "DN21767",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0206920",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9756892",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Belmont, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.