Individual provider Active NPI

Marina Shimshi, D.D.S.

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1811081755
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
046909 Issued in NY
Practice address
30 E 60TH St
Suite 503
New York, NY 10022-1008
Phone
(212) 752-3717
NPI assigned
Oct 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 046909 NY Primary

Addresses

Primary practice location

30 E 60TH St
Suite 503
New York, NY 10022-1008

Mailing address

30 E 60TH St
Suite 503
New York, NY 10022-1008
Phone (212) 752-3717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20191009003377 NY Order and Referring Only - DentistPractitioner - Dentist 4981935632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046909NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811081755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E 60TH ST",
            "address_2": "SUITE 503",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221008",
            "telephone_number": "212-752-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E 60TH ST",
            "address_2": "SUITE 503",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221008",
            "telephone_number": "212-752-3717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMSHI",
        "first_name": "MARINA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "046909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.