Individual provider Active NPI

Shivani Shirgavi, D.M.D.

  • Dentist
  • Brockton, MA
National Provider Identifier
1134596745
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1857064 Issued in MA
Practice address
70 Westgate Dr
Brockton, MA 02301-1811
Phone
(508) 872-3325
NPI assigned
Aug 31, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1857064 MA Primary

Addresses

Primary practice location

70 Westgate Dr
Brockton, MA 02301-1811

Mailing address

200 Falls Blvd Unit A104
Quincy, MA 02169-8145
Phone (302) 290-4877

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
DN1857064MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1134596745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 FALLS BLVD UNIT A104",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021698145",
            "telephone_number": "302-290-4877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 WESTGATE DR",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011811",
            "telephone_number": "508-872-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRGAVI",
        "first_name": "SHIVANI",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-31",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1857064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.