Active NPI
Sheela Kori, DDS
- Dentist
- Woodbridge, VA
National Provider Identifier
1124115761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401412649
- Practice address
- 2200 Opitz Blvd Ste 395
Woodbridge, VA 22191-3350 - Phone
- (703) 491-7695
- Fax
- (703) 490-0444
- NPI assigned
- Oct 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019.026841 | IL | |
| Dentist | 122300000X | 0401412649 | VA | Primary |
Addresses
Primary practice location
2200 Opitz Blvd Ste 395
Woodbridge, VA 22191-3350
Mailing address
2200 Opitz Blvd Ste 395
Woodbridge, VA 22191-3350
Phone (703) 491-7695
Other names 1
- Sheela Kori Virupannavar
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0401412649 | VA | MD | Dentist |
| 019.026841 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634601600000",
"number": "1124115761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 OPITZ BLVD STE 395",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221913350",
"telephone_number": "703-491-7695",
"fax_number": "703-490-0444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 OPITZ BLVD STE 395",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221913350",
"telephone_number": "703-491-7695",
"fax_number": "703-490-0444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORI",
"first_name": "SHEELA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-06",
"last_updated": "2021-10-19",
"certification_date": "2021-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019.026841",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401412649",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHEELA",
"last_name": "VIRUPANNAVAR",
"middle_name": "KORI",
"credential": "DDS",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.