Ailin Shan,DMD,PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401410938 Issued in VA

Legal business name

AILIN SHAN,DMD,PLLC

Practice address

5412 Glenside Dr
Suite C
Richmond, VA 23228-3995

Phone

(804) 756-6658

Fax

(804) 756-6662

NPI assigned

Mar 10, 2008

Last updated

Mar 10, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ailin Shan, DMD

Title

President

Phone

(804) 756-6658

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205107200000",
    "number": "1962672535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5412 GLENSIDE DR",
            "address_2": "SUITE C",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232283995",
            "telephone_number": "804-756-6658",
            "fax_number": "804-756-6662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5412 GLENSIDE DR",
            "address_2": "SUITE C",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232283995",
            "telephone_number": "804-756-6658",
            "fax_number": "804-756-6662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AILIN SHAN,DMD,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2008-03-10",
        "status": "A",
        "authorized_official_last_name": "SHAN",
        "authorized_official_first_name": "AILIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-756-6658",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9180406",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Richmond, VA
• Providers in Richmond, VA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.