Wayne Shim DMD LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

20756 Issued in MA

Legal business name

WAYNE SHIM DMD LLC

Practice address

241 King St Ste 220
Northampton, MA 01060-2344

Phone

(413) 586-4200

NPI assigned

Aug 9, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Wayne Shim, DMD

Title

President

Phone

(714) 383-4516

Specialties & licenses 1

Addresses

Other names 1

• Wayne Shim DMD Former legal business name

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502236800000",
    "number": "1962927103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13303 AVALON DR",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015322173",
            "telephone_number": "714-383-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 KING ST STE 220",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010602344",
            "telephone_number": "413-586-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE SHIM DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-09",
        "last_updated": "2017-08-09",
        "status": "A",
        "authorized_official_last_name": "SHIM",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-383-4516",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MA",
            "license": "20756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wayne Shim DMD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Ryan James Warner
• Binca C Warren, DMD
• Jennifer R Washington, RN
• Ethan Sherrerd Wattley, LMHC
• Sheryl S Waxler
• Robin Hamilton Bliss Wedell-Walker
• David Jonathan Weidenfeld, MSW, LICSW
• Thomas R. Weil, MD
• Amy Weinberg, ATC
• Brian Weinberger, B.A.

• Dental Clinic/Center in Northampton, MA
• Providers in Northampton, MA by specialty
• Dental Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2017; 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.