Mark Shain, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11860 Issued in MI

Practice address

6600 Highland Rd
Suite 23
Waterford, MI 48327-1673

Phone

(248) 666-1811

Fax

(248) 666-9142

NPI assigned

Sep 14, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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)

Enrolled

State licenses

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801881073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 HIGHLAND RD",
            "address_2": "SUITE 23",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271673",
            "telephone_number": "248-666-1811",
            "fax_number": "248-666-9142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 HIGHLAND RD",
            "address_2": "SUITE 23",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271673",
            "telephone_number": "248-666-1811",
            "fax_number": "248-666-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAIN",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "11860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Waterford, MI
• Providers in Waterford, MI by specialty
• General Practice Dentistry in Michigan

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.