Shiyuan Mao, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DEN03671 Issued in RI

Practice address

130 Granite St Ste C
Westerly, RI 02891-2461

Phone

(401) 596-8720

NPI assigned

Apr 1, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

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.

• Childrens Dentistry of Ri LLC

  • Dental Clinic/Center
  • Westerly, RI
  • NPI 1114680220
  NPD
• Childrens Dentistry of Westerly LLC

  • Pediatric Dentistry
  • Westerly, RI
  • NPI 1497980924
  NPD (past)

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1700464443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 GRANITE ST STE C",
            "city": "WESTERLY",
            "state": "RI",
            "postal_code": "028912461",
            "telephone_number": "401-596-8720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 GRANITE ST STE C",
            "city": "WESTERLY",
            "state": "RI",
            "postal_code": "028912461",
            "telephone_number": "401-596-8720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Salt Pond Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Wakefield",
            "state": "RI",
            "postal_code": "028794314",
            "country_code": "US",
            "telephone_number": "401-792-4664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAO",
        "first_name": "SHIYUAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-01",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "DC",
            "license": "DEN2000475",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "13933",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "RI",
            "license": "DEN03671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macyop LLC (OP Specialty Bracing)
• Salvatore F Magliari, OD
• Roy M Main, MD
• Gayle E. Maloney
• Mark J Mancini, MD
• Amy Marcille, OTR/L
• Jenay Arlene Martignetti, AGACNP
• Kristin Ann Martino, LICSW
• Fatima Martins Abbott, LICSW
• Nicholas Walter Martirossian, PA-C

• Pediatric Dentistry in Westerly, RI
• Providers in Westerly, RI by specialty
• Pediatric Dentistry in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.