Amie Shah

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

058278 Issued in NY

Practice address

315 Main St Ste 315-I
Holbrook, NY 11741-1524

Phone

(267) 210-1847

NPI assigned

Mar 12, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 8, 2022 through Jul 8, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1912323098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 ADDIS DR",
            "city": "CHURCHVILLE",
            "state": "PA",
            "postal_code": "189661170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MAIN ST STE 315-I",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411524",
            "telephone_number": "267-210-1847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "390 Amwell Rd Bldg 2",
            "address_purpose": "LOCATION",
            "city": "Hillsborough",
            "state": "NJ",
            "postal_code": "088441225",
            "country_code": "US",
            "telephone_number": "267-210-1847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "AMIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "058278",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "058278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Scott, O.D.
• Christina Marie Sears
• Lisa Ann Sessa, M.S. CCC-SLP
• Maryellen Sessa, RN
• Melissa Severino, RN, BSN
• Kaitlyn Shannon, RN
• Marie Lena Shannon, LMHC
• Ila Sharko, LPN
• Jonathan Sholder, PHARMD
• Foazia Siddiq, M.D.

• Pediatric Dentistry in Holbrook, NY
• Providers in Holbrook, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.