Individual provider Active NPI

Shilpi Gupta, DDS

  • Dentist
  • Mechanicsville, VA
National Provider Identifier
1053841908
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401415668 Issued in VA
Practice address
7522 Lee Davis Rd
Mechanicsville, VA 23111-3603
Phone
(804) 559-1016
NPI assigned
Jun 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401415668 VA Primary

Addresses

Primary practice location

7522 Lee Davis Rd
Mechanicsville, VA 23111-3603

Mailing address

12120 Liesfeld Pond Dr
Glen Allen, VA 23059-7094
Phone (412) 680-3891

Other identifiers 1

IdentifierTypeStateIssuer
1053841908OtherVANPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401415668VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
K J Lee DMD PC CurrentSince Feb 13, 2022 Accepting new patients

Locations

7522 Lee Davis Rd
Mechanicsville, VA 23111
Phone (804) 559-1016

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": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1053841908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12120 LIESFELD POND DR",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230597094",
            "telephone_number": "412-680-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7522 LEE DAVIS RD",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231113603",
            "telephone_number": "804-559-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "SHILPI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2022-02-08",
        "certification_date": "2022-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401415668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1053841908",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.