Igor Shilo, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D14960 Issued in MN

Practice address

7710 Brooklyn Blvd FL 1
Brooklyn Park, MN 55443-2979

Phone

(651) 292-9331

NPI assigned

Jul 31, 2023

Last updated

Jul 31, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• CLD - Brooklyn Park MN, LLC

  dba Clear Lakes Dental

  • Dental Clinic/Center
  • Brooklyn Park, MN
  • NPI 1770283475
  NPD
• Ignite Dental PLLC

  • General Practice Dentistry
  • Minneapolis, MN
  • NPI 1033052600
  NPD (past)

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1659052686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3730 W BROADWAY AVE UNIT 219",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554223678",
            "telephone_number": "651-515-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7710 BROOKLYN BLVD FL 1",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554432979",
            "telephone_number": "651-292-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHILO",
        "first_name": "IGOR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerry M Sheets, MD
• Shelter Arms2 Living LLC
• Shelterarm LLC
• Kassi Shiel, MA
• Shifaa Care Inc
• Victoria Shinners
• Stephen Joseph Shirola, OD
• Lotima Doto Shokiyo
• Stacy Shrestha, DNP, APRN, FNP-C
• Joseph J Sicora, M.D.

• Dentist in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.