Active NPI
Yuanfu Shek, DMD
- General Practice Dentistry
- Chelsea, MA
National Provider Identifier
1871669812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 21372
- Practice address
- 1100 Revere Beach Pkwy
Chelsea, MA 02150-1456 - Phone
- (617) 889-2090
- NPI assigned
- Nov 28, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 21372 | MA | Primary |
Addresses
Primary practice location
1100 Revere Beach Pkwy
Chelsea, MA 02150-1456
Mailing address
1100 Revere Beach Pkwy
Chelsea, MA 02150-1456
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0207616 | Medicaid | MA |
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 |
|---|---|---|---|
| 21372 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1871669812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 REVERE BEACH PKWY",
"city": "CHELSEA",
"state": "MA",
"postal_code": "021501456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 REVERE BEACH PKWY",
"city": "CHELSEA",
"state": "MA",
"postal_code": "021501456",
"telephone_number": "617-889-2090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEK",
"first_name": "YUANFU",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-28",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "21372",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0207616",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chelsea, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.