Individual provider Active NPI

Jennifer D'Silva, D.D.S.

  • Dentist
  • Charlotte, NC
National Provider Identifier
1174960181
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
260156 Issued in NC
Practice address
210 E Trade St # 484
Charlotte, NC 28202
Phone
(704) 632-7700
NPI assigned
May 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 057275 NY
Dentist 122300000X 260156 NC Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

210 E Trade St # 484
Charlotte, NC 28202

Mailing address

210 E Trade St # 484
Charlotte, NC 28202-2404
Phone (704) 632-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 6, 2023 through Mar 6, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
057275NYMDDentist
260156NCMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1174960181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E TRADE ST # 484",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022404",
            "telephone_number": "704-632-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E TRADE ST # 484",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28202",
            "telephone_number": "704-632-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'SILVA",
        "first_name": "JENNIFER",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-30",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "057275",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "260156",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.