NPI Code Detail JSON Logo

1396097044 NPI number — JILLY SHAO D.D.S

NPI Number: 1396097044
Health Care Provider/Practitioner: JILLY SHAO D.D.S

Information about “1396097044” NPI (JILLY SHAO D.D.S) exists in 1396097044 in HTML format HTML  |  1396097044 in plain Text format TXT  |  1396097044 in PDF (Portable Document Format) PDF  |  1396097044 in an XML format XML  formats.

NPI Number : 1396097044 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1396097044",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SHAO",
    "FirstName": "JILLY",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "D.D.S",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "18135 BELTRESS CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RICHMOND",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77407-2994",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "832-641-1879",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2320 B F TERRY BLVD STE 100",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ROSENBERG",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77471-6379",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "329-688-6508",
    "PracticeLocationAddressFaxNumber": "281-762-7359",
    "EnumerationDate": "10/04/2012",
    "LastUpdateDate": "03/07/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "122300000X",
        "TaxonomyName": "Dentist",
        "LicenseNumber": "30608",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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