Active NPI
Kevin Thomas Shay, D.D.S.
- Dentist
- Urbandale, IA
National Provider Identifier
1912913146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6442
- Practice address
- 7901 Douglas Ave
Suite a
Urbandale, IA 50322-2451 - Phone
- (515) 276-7800
- Fax
- (515) 276-8400
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 6442 | IA | Primary |
Addresses
Primary practice location
7901 Douglas Ave
Suite a
Urbandale, IA 50322-2451
Mailing address
7901 Douglas Ave
Suite a
Urbandale, IA 50322-2451
Phone (515) 276-7800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0005710 | Medicaid | IA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6442 | IA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912913146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7901 DOUGLAS AVE",
"address_2": "SUITE A",
"city": "URBANDALE",
"state": "IA",
"postal_code": "503222451",
"telephone_number": "515-276-7800",
"fax_number": "515-276-8400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7901 DOUGLAS AVE",
"address_2": "SUITE A",
"city": "URBANDALE",
"state": "IA",
"postal_code": "503222451",
"telephone_number": "515-276-7800",
"fax_number": "515-276-8400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAY",
"first_name": "KEVIN",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IA",
"license": "6442",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0005710",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Urbandale, IA
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.