Radmila Shuminov, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

059175 Issued in NY

Practice address

3071 Avenue U
Brooklyn, NY 11229-5122

Phone

(718) 736-0123

NPI assigned

Apr 22, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Radmila Rafailova Former name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

DentistAlso: Sleep Medicine

Education

New York University College of Dentistry, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Tru Smiles Dental of Huntington PLLC

  • Dentist
  • Huntington, NY
  • NPI 1336018183
  Medicare reassignment NPD Authorized official
• Bright White Dental, PLLC

  • General Practice Dentistry
  • Fresh Meadows, NY
  • NPI 1568611937
  NPD (past)

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1669826905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3071 AVENUE U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112295122",
            "telephone_number": "718-736-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3071 AVENUE U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112295122",
            "telephone_number": "718-736-0123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4802 10th Ave",
            "address_2": "4802 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112192916",
            "country_code": "US",
            "telephone_number": "718-283-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUMINOV",
        "first_name": "RADMILA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "059175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RADMILA",
            "last_name": "RAFAILOVA",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shuly Wigs Inc
• Colleen Shum
• Florence Shum, D.O.
• Yohana Shum, PA
• Maya Shumilova-Santos
• Anna Shur
• George Shur
• Michael Shur, OPTICIAN
• Natalya Shur, MSED
• Vladimir Shur, MD

• Dentist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.