Renee G Shongo, DMD, PA

Primary specialty

DentistTaxonomy code 122300000X

License

2575 Issued in SC

Practice address

163 Medical Cir
West Columbia, SC 29169-3655

Phone

(803) 794-0905

Fax

(803) 794-5472

NPI assigned

Feb 1, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1359676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1962741678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 MEDICAL CIR",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693655",
            "telephone_number": "803-794-0905",
            "fax_number": "803-794-5472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 MEDICAL CIR",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693655",
            "telephone_number": "803-794-0905",
            "fax_number": "803-794-5472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHONGO",
        "first_name": "RENEE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DMD, PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-01",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "2575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle W Sherwood, MD
• Mindi Owens Shifflett
• Rebekah Shilling, CCHW
• Brooke Shinkle, ATC
• Gabriela Shire, PT
• Robert Laforrest Shoun, D.M.D.
• Ronald J Shows, DC
• Janet Shufelt, MS RDN LD FAND
• Sara Katherine Shugart, PHARMD.
• Wesley H Shuler, M.D.

• Dentist in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; 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.

Verify at the official NPI Registry.