Richardson, Shanta Dianne
Richardson, Shanta Dianne is an individual health care provider with primary practice located at 8001 Hillsborough Rd Suite L, Ellicott City MD 21043-6876. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Richardson, Shanta Dianne can be contacted via phone (443) 574-8944.Contact Information
Primary practice address
8001 Hillsborough Rd Suite L
Ellicott City MD 21043-6876
Phone: (443) 574-8944
Fax: (443) 574-8947
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 21208 | Massachusetts |
Profile Details
| NPI number | 1205800729 |
|---|---|
| LBN Legal business name | Richardson, Shanta Dianne |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 13th, 2006 |
| Last updated | Sep 28th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205800729 | NPPES |
| Massachusetts | MEDICAID | 0208469 |
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