Active NPI
Ronak Shukla, DMD
- Dentist
- St Petersburg, FL
National Provider Identifier
1609259704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN 20521
- Practice address
- 3921 5TH Ave N
St Petersburg, FL 33713-7522 - Phone
- (727) 327-2342
- Fax
- (727) 327-5173
- NPI assigned
- Jul 7, 2015
- Sex
- Male
- 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 | DN 20521 | FL | Primary |
Addresses
Primary practice location
3921 5TH Ave N
St Petersburg, FL 33713-7522
Mailing address
3921 5TH Ave N
St Petersburg, FL 33713-7522
Phone (727) 327-2342
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jun 3, 2024 through Jun 3, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN 20521 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436227200000",
"number": "1609259704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3921 5TH AVE N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337137522",
"telephone_number": "727-327-2342",
"fax_number": "727-327-5173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3921 5TH AVE N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337137522",
"telephone_number": "727-327-2342",
"fax_number": "727-327-5173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUKLA",
"first_name": "RONAK",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-07",
"last_updated": "2015-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN 20521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.