Individual provider Active NPI

Richard Rongquan Shao

  • Dental Hygienist
  • Yonkers, NY
National Provider Identifier
1972212389
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
023512-01 Issued in NY
Practice address
984 N Broadway Ste 410
Yonkers, NY 10701-1308
Phone
(914) 476-3838
NPI assigned
Nov 15, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 023512-01 NY Primary

Addresses

Primary practice location

984 N Broadway Ste 410
Yonkers, NY 10701-1308

Mailing address

14962 45TH Ave
Flushing, NY 11355-1709
Phone (646) 886-6889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
023512-01NYMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Shay Markovitch Dentistry PLLC Dental Hygienist PastSince Nov 20, 2022 Accepting new patients
Stacie T Calian DDS PC PastSince Nov 20, 2022 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1972212389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14962 45TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551709",
            "telephone_number": "646-886-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984 N BROADWAY STE 410",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011308",
            "telephone_number": "914-476-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAO",
        "first_name": "RICHARD",
        "middle_name": "RONGQUAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NY",
            "license": "023512-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.