Individual provider Active NPI

Shenaz Rohinton Bhathena, DMD

  • General Practice Dentistry
  • Madison, WI
National Provider Identifier
1144913583
Registry record updated Oct 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6001214-15 Issued in WI
Practice address
1602 Fordem Ave Apt 114
Madison, WI 53704-4637
Phone
(608) 421-3142
NPI assigned
May 31, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019034287 IL
General Practice Dentistry 1223G0001X 6001214-15 WI Primary

Addresses

Primary practice location

1602 Fordem Ave Apt 114
Madison, WI 53704-4637

Mailing address

1602 Fordem Ave Apt 114
Madison, WI 53704-4637
Phone (608) 421-3142

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
019034287ILMDGeneral Practice Dentistry
6001214-15WIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697932800000",
    "number": "1144913583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 FORDEM AVE APT 114",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044637",
            "telephone_number": "608-421-3142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 FORDEM AVE APT 114",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044637",
            "telephone_number": "608-421-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHATHENA",
        "first_name": "SHENAZ",
        "middle_name": "ROHINTON",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-10-22",
        "certification_date": "2023-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019034287",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6001214-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2023; 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.