Shenika Cantrell, DMD, MBA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

102475 Issued in CA

Practice address

1340 Encinitas Blvd
Encinitas, CA 92024-2844

Phone

(760) 942-3900

NPI assigned

May 29, 2018

Sex

Female

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration

State licenses

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1659862373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3712 ROSEWOOD ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 ENCINITAS BLVD",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242844",
            "telephone_number": "760-942-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTRELL",
        "first_name": "SHENIKA",
        "name_prefix": "Dr.",
        "credential": "DMD, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-29",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "102475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Encinitas, CA
• Providers in Encinitas, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; 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.

Verify at the official NPI Registry.