Kishore Shetty, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019027546 Issued in IL

Practice address

425 N Date St
Escondido, CA 92025

Phone

(713) 517-2252

NPI assigned

Mar 16, 2007

Last updated

Apr 11, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 CA

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)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1386768398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 MABLEY PL",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275196940",
            "telephone_number": "713-517-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N DATE ST",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "92025",
            "telephone_number": "713-517-2252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "213 Mabley Pl",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275196940",
            "country_code": "US",
            "telephone_number": "713-517-2252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHETTY",
        "first_name": "KISHORE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Norman Sheehy, P.T.
• Ala Shehadeh
• Patrick Michael Shehane
• Rex Adam Sheridan, M.S.MFT
• Shilpi Sheth
• Amirsalar Sheykhsoltan, PHARMD
• Alvin K Shieh, MD
• Ariel M Shilling
• Alma Nereyda Shimabukuro, MASSAGE THERAPIST
• Hideo Shimizu, PH.D.

• Dentist in Escondido, CA
• Providers in Escondido, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.