Individual provider Active NPI

Marlina M Shah, DDS

  • Pediatric Dentistry
  • Lancaster, OH
National Provider Identifier
1851659163
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
30-023693 Issued in OH
Practice address
121 E 6TH Ave
Suite 101
Lancaster, OH 43130-2595
Phone
(740) 524-9372
NPI assigned
Apr 25, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.023693 OH
Pediatric Dentistry 1223P0221X 30-023693 OH Primary

Addresses

Primary practice location

121 E 6TH Ave
Suite 101
Lancaster, OH 43130-2595

Mailing address

121 E 6TH Ave
Suite 101
Lancaster, OH 43130-2595
Phone (740) 524-9372

Other practice location 1

380 Butterfly Gardens Dr
Columbus, OH 43215-7508
Phone (614) 722-5650

Other practice location 2

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-2000

Other identifiers 1

IdentifierTypeStateIssuer
0080535MedicaidOH

Other names 1

  • Dr. Marlina M Judd Former name

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

LicenseStateTypeSpecialty
30.023693OHMDDentist
30-023693OHMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nationwide Children'S Hospital Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1851659163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 E 6TH AVE",
            "address_2": "SUITE 101",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431302595",
            "telephone_number": "740-524-9372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 E 6TH AVE",
            "address_2": "SUITE 101",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431302595",
            "telephone_number": "740-524-9372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 Butterfly Gardens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432157508",
            "country_code": "US",
            "telephone_number": "614-722-5650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Childrens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052664",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MARLINA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-25",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.023693",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30-023693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0080535",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLINA",
            "last_name": "JUDD",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lancaster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.