Healthcare Provider Details

I. General information

NPI: 1497672596
Provider Name (Legal Business Name): VICTORIA SHEN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 KNEELAND ST
BOSTON MA
02111-1527
US

IV. Provider business mailing address

6509 LANGFORD CT
CLARKSVILLE MD
21029-1539
US

V. Phone/Fax

Practice location:
  • Phone: 781-527-4523
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDL101500
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: