Active NPI
Shruti Jadeja, DDS
- Dentist
- Happy Valley, OR
National Provider Identifier
1730535758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D10426
- Practice address
- 9997 SE 82ND Ave
Happy Valley, OR 97086-2301 - Phone
- (503) 902-1688
- NPI assigned
- May 9, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | D10426 | OR | Primary |
Addresses
Primary practice location
9997 SE 82ND Ave
Happy Valley, OR 97086-2301
Mailing address
6875 SW 144TH PL
Beaverton, OR 97008-5552
Phone (310) 404-7870
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160923001719 | OR | Order and Referring Only - Dentist | 1850688581 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D10426 | OR | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462752000000",
"number": "1730535758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6875 SW 144TH PL",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970085552",
"telephone_number": "310-404-7870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9997 SE 82ND AVE",
"city": "HAPPY VALLEY",
"state": "OR",
"postal_code": "970862301",
"telephone_number": "503-902-1688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JADEJA",
"first_name": "SHRUTI",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-09",
"last_updated": "2016-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D10426",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Happy Valley, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.