Kipa Shakya, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN10000846 Issued in MA

Practice address

30 Main St
Medford, MA 02155-7102

Phone

(781) 391-2440

NPI assigned

May 23, 2025

Sex

Female

Sole proprietor

No

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

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.

• Medford Square Dentistry and Implants LLC

  • Dental Clinic/Center
  • Medford, MA
  • NPI 1295400588
  NPD
• Nanette Demonteverde, DMD, PC

  • General Practice Dentistry
  • Medford, MA
  • NPI 1346463973
  NPD (past)

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

{
    "created_epoch": "1747958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1801689773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 MYSTIC VALLEY PKWY APT 118",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021556900",
            "telephone_number": "617-480-2062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MAIN ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021557102",
            "telephone_number": "781-391-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKYA",
        "first_name": "KIPA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-23",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN10000846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Selvaraj, DPT
• Jovan Emmanuel Sematimba, RN
• Eva Ray Senner, LICSW
• Debra R. Severo, RNCS
• Shafa Physical Therapy
• Yuliya Shanley, N.P.
• Susan Shannon
• Mia Shapiro, MA
• Ritu Sharma, PH.D.
• Sumesh Kumar Sharma, RPH

• Dentist in Medford, MA
• Providers in Medford, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.