Individual provider Active NPI

Sakshi Sharma, DDS BDS

  • Pediatric Dentistry
  • Muncie, IN
National Provider Identifier
1497197750
Registry record updated Sep 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
12012868A Issued in IN
Practice address
3905 N Wheeling Ave
Muncie, IN 47304
Phone
(765) 286-4017
Fax
(765) 286-0372
NPI assigned
Jul 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 12012868A IN Primary
General Practice Dentistry 1223G0001X 057520 NY

Addresses

Primary practice location

3905 N Wheeling Ave
Muncie, IN 47304

Mailing address

601B W Washington St
Geneva, NY 14456-2119
Phone (315) 781-8448

Other practice location 1

601B W Washington St
Geneva, NY 14456-2119
Phone (315) 781-8448

Other identifiers 2

IdentifierTypeStateIssuer
300012362MedicaidIN
057520OtherNYLICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
12012868AINMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Orthodontics of Indiana, LLC PastSince Sep 25, 2019 Accepting new patients
Jeffrey a. Rector, D.D.S., LLC Pediatric Dentistry 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, 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": "1374796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1497197750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601B W WASHINGTON ST",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144562119",
            "telephone_number": "315-781-8448",
            "fax_number": "315-781-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 N WHEELING AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "47304",
            "telephone_number": "765-286-4017",
            "fax_number": "765-286-0372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601B W Washington St",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "NY",
            "postal_code": "144562119",
            "country_code": "US",
            "telephone_number": "315-781-8448",
            "fax_number": "315-781-8444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "SAKSHI",
        "credential": "DDS BDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-26",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12012868A",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "057520",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300012362",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "057520",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.