Active NPI
Qinghong Shi
- General Practice Dentistry
- Ellicott City, MD
National Provider Identifier
1841201076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 13394
- Practice address
- 4785 Dorsey Hall Dr Ste 120
Ellicott City, MD 21042-7862 - Phone
- (443) 546-3403
- Fax
- (443) 546-3426
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 13394 | MD | Primary |
Addresses
Primary practice location
4785 Dorsey Hall Dr Ste 120
Ellicott City, MD 21042-7862
Mailing address
4785 Dorsey Hall Dr Ste 120
Ellicott City, MD 21042-7862
Phone (443) 546-3403
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13394 | MD | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365379200000",
"number": "1841201076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4785 DORSEY HALL DR STE 120",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210427862",
"telephone_number": "443-546-3403",
"fax_number": "443-546-3426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4785 DORSEY HALL DR STE 120",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210427862",
"telephone_number": "443-546-3403",
"fax_number": "443-546-3426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHI",
"first_name": "QINGHONG",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2013-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "13394",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellicott City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.