Lunan Shao, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12013650A Issued in IN

Practice address

7905 Indianapolis Blvd
Hammond, IN 46324

Phone

(219) 364-6388

NPI assigned

Jul 29, 2021

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1710650338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S STATE ST UNIT 1708",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7905 INDIANAPOLIS BLVD",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "46324",
            "telephone_number": "219-364-6388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6129 US Highway 6",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "IN",
            "postal_code": "463685058",
            "country_code": "US",
            "telephone_number": "219-364-6385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAO",
        "first_name": "LUNAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12013650A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Hammond, IN
• Providers in Hammond, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.