Active NPI
Mujibunnisa Shaik
- Dentist
- Dublin, CA
National Provider Identifier
1912321860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30775
- Practice address
- 4908 Hibernia Dr
Dublin, CA 94568-7553 - Phone
- (720) 288-9022
- NPI assigned
- Feb 12, 2014
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 30775 | TX | Primary |
Addresses
Primary practice location
4908 Hibernia Dr
Dublin, CA 94568-7553
Mailing address
6732 Coach House LN
Plano, TX 75023-3738
Phone (469) 837-0853
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220602000016 | TX | Practitioner - Dentist | 7315325438 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30775 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shine and Sparkle Dentistry PLLC | Current | Accepting new patients |
Locations
6505 W Park Blvd
Ste 132
Plano, TX 75093
Phone (972) 373-3786
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.
-
- General Practice Dentistry
- Plano, TX
- NPI 1457195448
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620777600000",
"number": "1912321860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6732 COACH HOUSE LN",
"city": "PLANO",
"state": "TX",
"postal_code": "750233738",
"telephone_number": "469-837-0853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4908 HIBERNIA DR",
"city": "DUBLIN",
"state": "CA",
"postal_code": "945687553",
"telephone_number": "720-288-9022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAIK",
"first_name": "MUJIBUNNISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-12",
"last_updated": "2021-05-12",
"certification_date": "2021-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "30775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dublin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.