Mark Rutledge McShane, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS041813 Issued in PA

Practice address

618TH Dental Company (As),
USA Dentac-Korea Unit #15660 BLDG # P 3020
Apo, AP 96271-5660

Phone

(315) 737-9186

NPI assigned

Aug 7, 2018

Last updated

Aug 7, 2018By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Whitman-Walker Clinic, Inc.

  dba Whitman Walker Health

  • Federally Qualified Health Center (FQHC)
  • Washington, DC
  • NPI 1821113341
  NPD (past)

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1972082451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "618TH DENTAL COMPANY (AS),",
            "address_2": "USA DENTAC-KOREA UNIT #15660 BLDG # P 3020",
            "city": "APO",
            "state": "AP",
            "postal_code": "962715660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "MIL",
            "address_1": "618TH DENTAL COMPANY (AS),",
            "address_2": "USA DENTAC-KOREA UNIT #15660 BLDG # P 3020",
            "city": "APO",
            "state": "AP",
            "postal_code": "962715660",
            "telephone_number": "315-737-9186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCSHANE",
        "first_name": "MARK",
        "middle_name": "RUTLEDGE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS041813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.