Active NPI
Shirley Chiamaka Austin, D.M.D.
- Dentist
- Fitchburg, MA
National Provider Identifier
1972732097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 100387
- Practice address
- 326 Nichols Rd BLDG
Fitchburg, MA 01420-1914 - Phone
- (718) 344-3648
- NPI assigned
- Jul 10, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN1855381 | MA | |
| Dentist | 122300000X | 100387 | CA | Primary |
Addresses
Primary practice location
326 Nichols Rd BLDG
Fitchburg, MA 01420-1914
Mailing address
332 Hanover St
Boston, MA 02113-1901
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181127002520 | MA | Order and Referring Only - Dentist | 3173797461 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100387 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649894400000",
"number": "1972732097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "332 HANOVER ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021131901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "326 NICHOLS RD BLDG",
"city": "FITCHBURG",
"state": "MA",
"postal_code": "014201914",
"telephone_number": "718-344-3648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUSTIN",
"first_name": "SHIRLEY",
"middle_name": "CHIAMAKA",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-10",
"last_updated": "2022-04-14",
"certification_date": "2022-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN1855381",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "100387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fitchburg, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; 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.