Individual provider Active NPI

Pragnya Sheelam, DDS

  • Dentist
  • Tacoma, WA
National Provider Identifier
1336627751
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60876582 Issued in WA
Practice address
1148 72ND St E Unit B
Tacoma, WA 98404-1806
Phone
(253) 537-5437
Fax
(253) 537-5438
NPI assigned
Jul 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60876582 WA Primary

Addresses

Primary practice location

1148 72ND St E Unit B
Tacoma, WA 98404-1806

Mailing address

5401 6TH Ave Ste 201
Tacoma, WA 98406-2618
Phone (253) 759-5437

Other practice location 1

1901 S Union Ave Ste B3008
Tacoma, WA 98405-1803
Phone (253) 572-9777

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DE60876582WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
George C. Brain DDS PC Past Accepting new patients
Smiles 4 Kids Allenmore, P.C. 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1336627751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 6TH AVE STE 201",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984062618",
            "telephone_number": "253-759-5437",
            "fax_number": "253-428-1836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1148 72ND ST E UNIT B",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984041806",
            "telephone_number": "253-537-5437",
            "fax_number": "253-537-5438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 S Union Ave Ste B3008",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984051803",
            "country_code": "US",
            "telephone_number": "253-572-9777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEELAM",
        "first_name": "PRAGNYA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60876582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; 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.