Shreya Tushar Thakkar, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

40246 Issued in TX

Practice address

1500 Commons Cir Ste 100
Northlake, TX 76226-2717

Phone

(469) 307-5093

NPI assigned

Jul 6, 2021

Sex

Female

Sole proprietor

No

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.

• PMP - Northlake PLLC

  • General Practice Dentistry
  • Northlake, TX
  • NPI 1427913227

  General Practice

  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 20, 2024.

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1144891722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 ESCENA BLVD APT 2161",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750394372",
            "telephone_number": "847-769-1836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 COMMONS CIR STE 100",
            "city": "NORTHLAKE",
            "state": "TX",
            "postal_code": "762262717",
            "telephone_number": "469-307-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKKAR",
        "first_name": "SHREYA",
        "middle_name": "TUSHAR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61180157",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "40246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natasha Suzanne Smithey, RN, FNP-C
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• Margaret Stinnett, DNP, APRN, FNP-BC
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• Paola Sveter, LMFT-A
• Denny Thomas, OD
• Sydney Michelle Thompson, OD
• Junior Tobias, D.D.S.
• Today Dental of Northlake
• Total Set Solutions LLC

• All providers in Northlake, TX
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; 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.