Shruthi Venugopalakrishnan

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DENT.DE.70007756 Issued in WA

Practice address

25610 104TH Ave SE
Kent, WA 98030-7610

Phone

(206) 913-7272

NPI assigned

Feb 24, 2025

Last updated

Aug 21, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1154127710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25610 104TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25610 104TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307610",
            "telephone_number": "206-913-7272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "UW Department of Oral Surgery-1959 NE Pacific Street",
            "address_2": "BOX 357134",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98195",
            "country_code": "US",
            "telephone_number": "206-913-7272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENUGOPALAKRISHNAN",
        "first_name": "SHRUTHI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DENT.DE.70007756",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauryn Vaughn
• Aleksandr Velit
• Mia Venheim
• Lacey Ventura
• Rodrigo Ventura
• Andrea P Verner, PCD, CLE, CBE
• Ahkia Veshay
• Virginia Lee Vessecchia, LPN
• Shelley K. Vessey, P.T.
• Victoria Robert's Salon & Spa

• General Practice Dentistry in Kent, WA
• Providers in Kent, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.