Active NPI
Patricia A Shinin, DMD
- General Practice Dentistry
- Concord, MA
National Provider Identifier
1902982317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 18953
- Practice address
- 290 Baker Ave
Suite S 104
Concord, MA 01742 - Phone
- (978) 369-6611
- Fax
- (948) 371-3041
- NPI assigned
- Oct 27, 2006
- Sex
- Female
- 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 | 18953 | MA | Primary |
Addresses
Primary practice location
290 Baker Ave
Suite S 104
Concord, MA 01742
Mailing address
290 Baker Ave
Suite S 104
Concord, MA 01742
Phone (978) 369-6611
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 |
|---|---|---|---|
| 18953 | MA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark Y Wang | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902982317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "290 BAKER AVE",
"address_2": "SUITE S 104",
"city": "CONCORD",
"state": "MA",
"postal_code": "01742",
"telephone_number": "978-369-6611",
"fax_number": "948-371-3041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 BAKER AVE",
"address_2": "SUITE S 104",
"city": "CONCORD",
"state": "MA",
"postal_code": "01742",
"telephone_number": "978-369-6611",
"fax_number": "948-371-3041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHININ",
"first_name": "PATRICIA",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "18953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, MA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.