Shalini Mittal, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

38304 Issued in TX

Practice address

1468 E Whitestone Blvd Ste 500
Cedar Park, TX 78613-0019

Phone

(612) 584-7767

NPI assigned

Jul 12, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683

  MN

  Medicare reassignment NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Blaine, MN
  • NPI 1699829697

  General Practice

  NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053

  Dentist

  NPD
• Blaine Dentistry, PC

  • General Practice Dentistry
  • Blaine, MN
  • NPI 1982007803

  General Practice

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1104302124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2618 KRAMER LN APT 5091",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787580073",
            "telephone_number": "612-584-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 E WHITESTONE BLVD STE 500",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786130019",
            "telephone_number": "612-584-7767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1665 Utica Ave S Ste 100",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "55416",
            "country_code": "US",
            "telephone_number": "952-541-2700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1384 109th Ave NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Blaine",
            "state": "MN",
            "postal_code": "554344543",
            "country_code": "US",
            "telephone_number": "763-757-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "531 Maryland Ave NE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "20002",
            "country_code": "US",
            "telephone_number": "202-470-5873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITTAL",
        "first_name": "SHALINI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "14131",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "38304",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "DEN1001884",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Beth Ming Ulloa, DC
• Vanessa Tran Minnick, O.D.
• James Gordon Minto Jr., MSW, LCSW
• Kyla Mione, LPC
• Ketakumari Mistry, PHARM. D. R.PH.
• Joda Kay Miura, LCSW
• Lori D Mock-Blair, PA-C
• Virginia Jane Mock, O.D.
• Alyssa Lee Moffitt, OTR
• Javier Molina, RPH

• All providers in Cedar Park, TX
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.