Theodore Richard Shille, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN.00010513 Issued in CO

Practice address

3525 W Oxford Ave Unit G-3
Denver, CO 80236-3115

Phone

(303) 315-6150

Fax

(720) 259-4559

NPI assigned

Jun 17, 2011

Last updated

Oct 5, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Metro Community Provider Network Inc

  dba STRIDE Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Aurora, CO
  • NPI 1558727883
  Medicare reassignment NPD
• Metro Community Provider Network Inc

  dba STRIDE Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Arvada, CO
  • NPI 1376701300
  NPD
• Metro Community Provider Network, Inc.

  dba STRIDE CHC - Peoria Pharmacy

  • Community/Retail Pharmacy
  • Aurora, CO
  • NPI 1255591780
  NPD
• The Regents of the University of Colorado

  dba Sheridan Health Services

  • Federally Qualified Health Center (FQHC)
  • Denver, CO
  • NPI 1750657722
  NPD
• The Regents of the University of Colorado

  dba CU Youth Health Clinic at Urban Peak

  • Federally Qualified Health Center (FQHC)
  • Denver, CO
  • NPI 1982425674
  NPD (past)

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1962797829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 W OXFORD AVE UNIT G-3",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802363115",
            "telephone_number": "303-315-6150",
            "fax_number": "720-259-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 W OXFORD AVE UNIT G-3",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802363115",
            "telephone_number": "303-315-6150",
            "fax_number": "720-259-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHILLE",
        "first_name": "THEODORE",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-17",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00010513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60886374",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Holly Lee Shih, LCSW
• Tianchu Shih, DO
• Erin Shill, M.S. CCC-SLP
• Shiloh Home Inc (Shiloh House)
• Richelle Shimek, MS, CCC-SLP
• Amanda Lynn Shimkus, OT
• Rozaliya Shimonova, O.D.
• Naomi Shin

• General Practice Dentistry in Denver, CO
• Providers in Denver, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.