Individual provider Active NPI

Yasas Shri Nalaka Jayaratne, BDS, MDS, PHD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Pearland, TX
National Provider Identifier
1205242427
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
33468 Issued in TX
Practice address
11021 Shadow Creek Pkwy Ste 108
Pearland, TX 77584-7401
Phone
(281) 241-1411
Fax
(281) 241-4345
NPI assigned
Jul 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 33468 TX Primary

Addresses

Primary practice location

11021 Shadow Creek Pkwy Ste 108
Pearland, TX 77584-7401

Mailing address

24601 Southwest Fwy Ste 200
Rosenberg, TX 77471-6266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160415001937 CT Order and Referring Only - DentistPractitioner - Dentist 2769780220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
33468TXMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pearland Smiles PLLC Orthodontics and Dentofacial Orthopedics CurrentSince Jun 2, 2024 Accepting new patients

Locations

11021 Shadow Creek Pkwy
#108
Pearland, TX 77584
Phone (281) 241-1411

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1205242427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24601 SOUTHWEST FWY STE 200",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774716266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11021 SHADOW CREEK PKWY STE 108",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847401",
            "telephone_number": "281-241-1411",
            "fax_number": "281-241-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYARATNE",
        "first_name": "YASAS",
        "middle_name": "SHRI NALAKA",
        "name_prefix": "Dr.",
        "credential": "BDS, MDS, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-08",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "33468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

Verify at the official NPI Registry.