Active NPI
Naresh Yedthare Shetty, BDS, MDS, PHD
- Oral and Maxillofacial Surgery (Dentist)
- Dallas, TX
National Provider Identifier
1366330631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 41370
- Practice address
- 3000 Gaston Ave
Dallas, TX 75226-1309 - Phone
- (945) 225-1128
- NPI assigned
- Jun 25, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 41370 | TX | Primary |
Addresses
Primary practice location
3000 Gaston Ave
Dallas, TX 75226-1309
Mailing address
3000 Gaston Ave
Dallas, TX 75226-1309
Phone (945) 225-1128
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41370 | TX | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750809600000",
"number": "1366330631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 GASTON AVE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752261309",
"telephone_number": "945-225-1128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 GASTON AVE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752261309",
"telephone_number": "945-225-1128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHETTY",
"first_name": "NARESH",
"middle_name": "YEDTHARE",
"name_prefix": "Dr.",
"credential": "BDS, MDS, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-06-25",
"last_updated": "2025-06-25",
"certification_date": "2025-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "TX",
"license": "41370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.