Individual provider Active NPI

Shawn P McMahon, DDS, MS

  • Orofacial Pain Dentistry
  • Richmond, VA
National Provider Identifier
1982681771
Registry record updated Dec 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orofacial Pain DentistryTaxonomy code 1223X2210X
License
VA0401416696 Issued in VA
Practice address
521 N 11TH St
Richmond, VA 23298-5045
Phone
(804) 828-9363
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D12080 MN
Orofacial Pain Dentistry 1223X2210X VA0401416696 VA Primary

Addresses

Primary practice location

521 N 11TH St
Richmond, VA 23298-5045

Mailing address

521 N 11TH St
Richmond, VA 23298-5045
Phone (804) 828-9363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20200413002755 VA Practitioner - Dentist 3072943182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
University of Minnesota School of Dentistry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vcu Oral-Facial Surgery and Services LLCGroup PAC ID 7416349022, 7 clinicians

Practice addresses (Care Compare)

401 N 11TH St
Richmond, VA 23219-1901
Phone (804) 828-3769

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
D12080MNMDDentist
VA0401416696VAMDOrofacial Pain Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Vcu Oral-Facial Surgery and Services LLC Orofacial Pain CurrentSince Aug 20, 2021 Accepting new patients

Locations

1250 E Marshall St
Richmond, VA 23298
Phone (804) 628-6990

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

521 N 11th St
Richmond, VA 23298
Phone (804) 828-3368

520 N 12th St
Richmond, VA 23298
Phone (804) 628-6637

Organizations & group practices 1

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1982681771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 N 11TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985045",
            "telephone_number": "804-828-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 N 11TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985045",
            "telephone_number": "804-828-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHON",
        "first_name": "SHAWN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12080",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "VA",
            "license": "VA0401416696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.