Individual provider Active NPI

Maria M Shayan, DMD

  • Dentist
  • Coral Springs, FL
National Provider Identifier
1700172673
Registry record updated Jun 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN19381 Issued in FL
Practice address
10339 W Sample Rd
Coral Springs, FL 33065-3941
Phone
(954) 840-1939
Fax
(954) 840-1940
NPI assigned
Jun 20, 2011
Last updated
Jun 20, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN19381 FL Primary

Addresses

Primary practice location

10339 W Sample Rd
Coral Springs, FL 33065-3941

Mailing address

4040 NW 88TH Ave Apt 2D
Sunrise, FL 33351-6524
Phone (954) 552-9091

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

LicenseStateTypeSpecialty
DN19381FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Vultaggio Dentistry of Coral Springs,LLC Past Accepting new patients

Networks

  • Freedom Health HMO Network

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": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1700172673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 NW 88TH AVE APT 2D",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516524",
            "telephone_number": "954-552-9091",
            "fax_number": "954-840-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10339 W SAMPLE RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653941",
            "telephone_number": "954-840-1939",
            "fax_number": "954-840-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAYAN",
        "first_name": "MARIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; 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.