Avisha Rakesh Shah, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

0401416849 Issued in VA

Practice address

3712 Old Forest Rd Ste 100
Lynchburg, VA 24501-6963

Phone

(434) 385-0273

Fax

(434) 385-6269

NPI assigned

Jun 29, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lynchburg Endodontics P.C.

  • Endodontics
  • Lynchburg, VA
  • NPI 1922748052
  NPD
• James L. Stanley, D.D.S., P.C.

  • Endodontics
  • Lynchburg, VA
  • NPI 1750495487
  NPD (past)

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1225655939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11841 TROPHY CLUB DR APT 207-4",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231131472",
            "telephone_number": "310-402-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3712 OLD FOREST RD STE 100",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245016963",
            "telephone_number": "434-385-0273",
            "fax_number": "434-385-6269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "AVISHA",
        "middle_name": "RAKESH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "0401416849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynnette L Shadoan
• Jennifer Shadrick, BCBA/LBA
• Molly Shafer, LPC
• Kristopher Marshall Dean Shaffer, LPC
• Melissa Jean Shaffron, PA-C
• Kalyani Sudhir Shah, NP
• Abdul Shaikh
• Sanobar Shaikh
• Shannon Sawyer DMD, Inc.
• Joleen Sharp

• Endodontics in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Endodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.