Active NPI
Shradha Lyttle, D.D.S.
- Dentist
- Denton, TX
National Provider Identifier
1437572005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 29077
- Practice address
- 2430 S Interstate 35 E # South
Suite 210
Denton, TX 76205-4986 - Phone
- (940) 387-2214
- NPI assigned
- Feb 1, 2014
- Last updated
- Jan 22, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 29077 | TX | Primary |
Addresses
Primary practice location
2430 S Interstate 35 E # South
Suite 210
Denton, TX 76205-4986
Mailing address
2430 S Interstate 35 E Ste 210
Denton, TX 76205-4944
Phone (402) 452-8315
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150730013533 | TX | Order and Referring Only - Dentist | 2163736489 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29077 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lillian Miller Dental | Dentist | Past | 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": "1391212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579651200000",
"number": "1437572005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2430 S INTERSTATE 35 E STE 210",
"city": "DENTON",
"state": "TX",
"postal_code": "762054944",
"telephone_number": "402-452-8315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2430 S INTERSTATE 35 E # SOUTH",
"address_2": "SUITE 210",
"city": "DENTON",
"state": "TX",
"postal_code": "762054986",
"telephone_number": "940-387-2214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYTTLE",
"first_name": "SHRADHA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-01",
"last_updated": "2020-01-22",
"certification_date": "2020-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "29077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Denton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.