Individual provider Active NPI

Shilpa Kolhatkar, DDS, MDS

  • Periodontics
  • Plymouth, MI
National Provider Identifier
1598857336
Registry record updated Jan 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
2901018336 Issued in MI
Practice address
40400 Ann Arbor Rd E
Suite 204a
Plymouth, MI 48170-6615
Phone
(734) 459-4077
NPI assigned
Sep 29, 2006
Last updated
Jan 31, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 2901018336 MI Primary

Addresses

Primary practice location

40400 Ann Arbor Rd E
Suite 204a
Plymouth, MI 48170-6615

Mailing address

40400 Ann Arbor Rd E
Suite 204a
Plymouth, MI 48170-6615
Phone (734) 459-4077

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
2901018336MIMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Periodontic PLLC Periodontics Past Accepting new patients
Advanced Periodontics/Implantology Periodontics 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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454198400000",
    "number": "1598857336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40400 ANN ARBOR RD E",
            "address_2": "SUITE 204A",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706615",
            "telephone_number": "734-459-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40400 ANN ARBOR RD E",
            "address_2": "SUITE 204A",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706615",
            "telephone_number": "734-459-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLHATKAR",
        "first_name": "SHILPA",
        "name_prefix": "Ms.",
        "credential": "DDS, MDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2016-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "2901018336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2016; 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.