Gregory M. Shupik, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

22DI00971800 Issued in NJ

Practice address

1910 Marlton Pike E
Suite 2
Cherry Hill, NJ 08003-2123

Phone

(856) 428-4746

Fax

(856) 751-3975

NPI assigned

Feb 13, 2007

Sex

Male

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

Enrolled in NJ

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

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.

• Gregory M. Shupik, D.M.D., P.a.

  • Periodontics
  • Cherry Hill, NJ
  • NPI 1053538116
  NPD (past) Authorized official
• Periodontal Consultants, PA

  • Periodontics
  • Cherry Hill, NJ
  • NPI 1417502378
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740322296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 MARLTON PIKE E",
            "address_2": "SUITE 2",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032123",
            "telephone_number": "856-428-4746",
            "fax_number": "856-751-3975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 MARLTON PIKE E",
            "address_2": "SUITE 2",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032123",
            "telephone_number": "856-428-4746",
            "fax_number": "856-751-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUPIK",
        "first_name": "GREGORY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DI00971800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michaela Scotten Shuhnicki, MSOT, OTR/L
• Chirag Shukla, PHARMD
• Dhara Mayank Shukla, PHARMD
• Jonathan Shulman
• Megan E Shulman, OT
• Sicklerville Internal Medicine
• Faisal Khursheed Siddiqi, M.D
• Alan Siedman, O.D.
• Scott L Siegal, DO
• Annastasia Sigafoos

• Periodontics in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Periodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.