NPIMap

Individual provider Active NPI

Amisha N Shroff, D.D.S

  • Dentist
  • Bethesda, MD
National Provider Identifier
1649265703
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13054 Issued in MD
Practice address
10320 Westlake Dr
109
Bethesda, MD 20817-6448
Phone
(301) 469-4775
Fax
(301) 469-4776
NPI assigned
Sep 15, 2005
Reactivated
Mar 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 13054 MD Primary

Addresses

Primary practice location

10320 Westlake Dr
109
Bethesda, MD 20817-6448

Mailing address

10320 Westlake Dr
109
Bethesda, MD 20817-6448
Phone (301) 469-4775

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
13054MDMDClinical Social Worker

Organizations & group practices 3

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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1649265703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10320 WESTLAKE DR",
            "address_2": "109",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208176448",
            "telephone_number": "301-469-4775",
            "fax_number": "301-469-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10320 WESTLAKE DR",
            "address_2": "109",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208176448",
            "telephone_number": "301-469-4775",
            "fax_number": "301-469-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHROFF",
        "first_name": "AMISHA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-15",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "deactivation_date": "2006-03-23",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "13054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.