Individual provider Active NPI

Danoosh Shiravand Amrooei, D.M.D

  • Dentist
  • Riverview, FL
National Provider Identifier
1689838666
Registry record updated Jul 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18364 Issued in FL
Practice address
10845 W Bloomingdale Ave
Riverview, FL 33569
Phone
(813) 662-6100
NPI assigned
Jul 18, 2008
Last updated
Jul 18, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 18364 FL Primary

Addresses

Primary practice location

10845 W Bloomingdale Ave
Riverview, FL 33569

Mailing address

16569 Hutchison Rd
Odessa, FL 33556-2325
Phone (813) 230-6762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160218001336 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6103121876

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18364FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lillybash Dental Studio PLLC Current Accepting new patients
DSL Dental Studio PLLC Current 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": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216339200000",
    "number": "1689838666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16569 HUTCHISON RD",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335562325",
            "telephone_number": "813-230-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10845 W BLOOMINGDALE AVE",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "33569",
            "telephone_number": "813-662-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMROOEI",
        "first_name": "DANOOSH",
        "middle_name": "SHIRAVAND",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-18",
        "last_updated": "2008-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "18364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

Verify at the official NPI Registry.