Individual provider Active NPI

Shrina Jasani

  • Dentist
  • Arvada, CO
National Provider Identifier
1225848575
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
00206186 Issued in CO
Practice address
14807 W 64TH Ave Unit C
Arvada, CO 80007-0104
Phone
(303) 456-4095
NPI assigned
Jan 9, 2025
Last updated
Feb 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 00206186 CO Primary

Addresses

Primary practice location

14807 W 64TH Ave Unit C
Arvada, CO 80007-0104

Mailing address

14807 W 64TH Ave Unit C
Arvada, CO 80007-0104
Phone (303) 456-4095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20250808002898 CO Order and Referring Only - DentistPractitioner - Dentist 5193223188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00206186COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Arvada Modern Dentistry, LLP Multi-Specialty PastSince Feb 23, 2025 Accepting new patients

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, 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": "1736380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1225848575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14807 W 64TH AVE UNIT C",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800070104",
            "telephone_number": "303-456-4095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14807 W 64TH AVE UNIT C",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800070104",
            "telephone_number": "303-456-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASANI",
        "first_name": "SHRINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "00206186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

Verify at the official NPI Registry.