Individual provider Active NPI

Manish Vallabh Sheladia, D.M.D.

  • General Practice Dentistry
  • Gastonia, NC
National Provider Identifier
1568529907
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
08475 Issued in NC
Practice address
825 Majestic CT
Ste. C
Gastonia, NC 28054-5186
Phone
(704) 864-6721
Fax
(704) 864-1175
NPI assigned
Jan 3, 2007
Last updated
Sep 3, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 08475 NC Primary

Addresses

Primary practice location

825 Majestic CT
Ste. C
Gastonia, NC 28054-5186

Mailing address

825 Majestic CT
Ste. C
Gastonia, NC 28054-5186
Phone (704) 864-6721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20160601000814 NC Order and Referring Only - DentistPractitioner - Dentist 9436449683

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Manish V Sheladia DMD Past Accepting new patients
Gary P Weller DDS PA General Practice 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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378166400000",
    "number": "1568529907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 MAJESTIC CT",
            "address_2": "STE. C",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545186",
            "telephone_number": "704-864-6721",
            "fax_number": "704-864-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 MAJESTIC CT",
            "address_2": "STE. C",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545186",
            "telephone_number": "704-864-6721",
            "fax_number": "704-864-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELADIA",
        "first_name": "MANISH",
        "middle_name": "VALLABH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2013-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "08475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.