Priyanka Shukla, BDS,MS

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

9731 Issued in MA

Practice address

1425 Blue Hill Ave
Mattapan, MA 02126-2253

Phone

(617) 296-0061

NPI assigned

Nov 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Boston University Medical Center Radiologists, Inc.

  • Diagnostic Radiology Physician
  • Boston, MA
  • NPI 1134166945
  NPD (past)
• Mattapan Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Mattapan, MA
  • NPI 1639240393
  NPD (past)

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1134301385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 BLUE HILL AVE",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262253",
            "telephone_number": "617-296-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 BLUE HILL AVE",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262253",
            "telephone_number": "617-296-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "PRIYANKA",
        "name_prefix": "Dr.",
        "credential": "BDS,MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-29",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "MA",
            "license": "9731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabelle Christine Scarnavack
• Michelle Sealy, RN
• Christopher W Shanahan, M.D., M.P.H.
• Kelsey Beth Sheehan, PHARMD, RPH
• Robert Brett Sherry, D.C.
• Corinne Sieben
• Sisterhood on the Move
• Celia H. Smith, MSW
• Dorothy Isles Smith, LCSW
• La Tanya Smith, M.A.

• Public Health Dentistry in Mattapan, MA
• Providers in Mattapan, MA by specialty
• Public Health Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.