Individual provider Active NPI

Archana Shettikere Shankaralingappa, D.D.S

  • General Practice Dentistry
  • Orlando, FL
National Provider Identifier
1164686770
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS045144 Issued in PA
Practice address
5730 Lake Underhill Rd
Orlando, FL 32807-4366
Phone
(407) 322-8645
NPI assigned
Jul 12, 2008
Last updated
Jun 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22231 MA
General Practice Dentistry 1223G0001X DS045144 PA Primary
General Practice Dentistry 1223G0001X DN23308 FL

Addresses

Primary practice location

5730 Lake Underhill Rd
Orlando, FL 32807-4366

Mailing address

4930 E Lake Mary Blvd
Sanford, FL 32771-5003
Phone (407) 322-8645

Other practice location 1

664 SW Wilshire Blvd
Burleson, TX 76028-5851
Phone (817) 426-3331

Other practice location 2

445 State Road 13 Ste 22
Jacksonville, FL 32259
Phone (904) 209-6590

Other identifiers 1

IdentifierTypeStateIssuer
100303200MedicaidFL

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS045144PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Dental P.a. PastSince Jun 22, 2021 Accepting new patients
Coast Dental P.a. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1215820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1164686770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 E LAKE MARY BLVD",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327715003",
            "telephone_number": "407-322-8645",
            "fax_number": "407-269-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5730 LAKE UNDERHILL RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328074366",
            "telephone_number": "407-322-8645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "664 SW Wilshire Blvd",
            "address_purpose": "LOCATION",
            "city": "Burleson",
            "state": "TX",
            "postal_code": "760285851",
            "country_code": "US",
            "telephone_number": "817-426-3331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "445 State Road 13 Ste 22",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "32259",
            "country_code": "US",
            "telephone_number": "904-209-6590",
            "fax_number": "904-209-6595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANKARALINGAPPA",
        "first_name": "ARCHANA",
        "middle_name": "SHETTIKERE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-12",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "22231",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS045144",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN23308",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100303200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.