Irina Shamalova, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

052022-1 Issued in NY

Practice address

2071 2ND Ave
New York, NY 10029-4101

Phone

(212) 410-6969

Fax

(212) 410-6989

NPI assigned

Jan 22, 2007

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

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871647677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9941 64TH AVE",
            "address_2": "APT. A12",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742653",
            "telephone_number": "917-749-6330",
            "fax_number": "212-410-6989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2071 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100294101",
            "telephone_number": "212-410-6969",
            "fax_number": "212-410-6989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMALOVA",
        "first_name": "IRINA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "052022-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02771093",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "9184884",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karim Shama
• Sharon Lenore Shamah, SPECIAL EDUCATOR
• Steven Shamah, M.D.
• Joshua Shamalov
• Mariana Shamalov
• Meredith Kerry Shamamian
• Peter Edward Shamamian Jr., MD
• Jennifer Rivka Shamash
• Shahrokh Shamashian, RPH
• Nancy Mae Shamban, RN, LP

• Dentist in New York, NY
• Providers in New York, NY by specialty
• Dentist in New York

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.