Individual provider Active NPI

Nishchal Mukesh Dalal, DDS

  • Dentist
  • Charlottesville, VA
National Provider Identifier
1710588488
Registry record updated Nov 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401417086 Issued in VA
Practice address
2003 Woodbrook CT
Charlottesville, VA 22901-1148
Phone
(434) 975-6181
NPI assigned
Nov 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 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 0401417086 VA Primary

Addresses

Primary practice location

2003 Woodbrook CT
Charlottesville, VA 22901-1148

Mailing address

12515 Nathaniel Oaks Dr
Herndon, VA 20171-1732
Phone (703) 300-8339

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
0401417086VAMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604793600000",
    "number": "1710588488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12515 NATHANIEL OAKS DR",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201711732",
            "telephone_number": "703-300-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 WOODBROOK CT",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229011148",
            "telephone_number": "434-975-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALAL",
        "first_name": "NISHCHAL",
        "middle_name": "MUKESH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-08",
        "last_updated": "2020-11-08",
        "certification_date": "2020-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401417086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.