Individual provider Active NPI

Shannon Andrews Kittrell, DDS

  • Dentist
  • Richmond, VA
National Provider Identifier
1437635331
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401416170 Issued in VA
Practice address
8804 Patterson Ave Ste 100
Richmond, VA 23229-6361
Phone
(804) 740-7212
Fax
(804) 741-6009
NPI assigned
Jul 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 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 0401416170 VA Primary

Addresses

Primary practice location

8804 Patterson Ave Ste 100
Richmond, VA 23229-6361

Mailing address

8804 Patterson Ave Ste 100
Richmond, VA 23229-6361
Phone (804) 740-7212

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
0401416170VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Brian Midgette, DDS, PLLC PastSince Jun 21, 2020 Accepting new patients
Virginia Dental Sleep Solutions, LLC 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": "1531440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1437635331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8804 PATTERSON AVE STE 100",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232296361",
            "telephone_number": "804-740-7212",
            "fax_number": "804-741-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8804 PATTERSON AVE STE 100",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232296361",
            "telephone_number": "804-740-7212",
            "fax_number": "804-741-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITTRELL",
        "first_name": "SHANNON",
        "middle_name": "ANDREWS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-13",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401416170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.