Janaki Vimlesh Shukla, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019030550 Issued in IL

Practice address

126 Union St
Marlborough, MA 01752-1207

Phone

(508) 481-4200

NPI assigned

Jul 25, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1720334956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 W BURTON PL",
            "address_2": "APT. 2007",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606101444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 UNION ST",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017521207",
            "telephone_number": "508-481-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "JANAKI",
        "middle_name": "VIMLESH",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1856398",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019030550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittney Avis Sherillo, B.A.
• Kashmir Sherman
• Crystal Lashay Shields, BT
• Sarah L Shoemaker
• Sharon Shoemaker
• Krystal Shumskiy
• Danielle Sibilio
• Lynn Marie Sicuro, R.P.T.
• Daniel T Sidoti
• Ephraim Sieber

• General Practice Dentistry in Marlborough, MA
• Providers in Marlborough, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.