Individual provider Active NPI

Sheldon Anthony Bates, D.M.D., M.S.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Henrico, VA
National Provider Identifier
1740536663
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
0401413495 Issued in VA
Practice address
3800 Stillman Pkwy
Suite 101
Henrico, VA 23233-1455
Phone
(804) 934-9292
Fax
(804) 934-9290
NPI assigned
Jul 29, 2012
Last updated
Jan 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 0401413495 VA Primary

Addresses

Primary practice location

3800 Stillman Pkwy
Suite 101
Henrico, VA 23233-1455

Mailing address

3800 Stillman Pkwy
Suite 101
Henrico, VA 23233-1455
Phone (804) 934-9292

Other practice location 1

3404 Hermitage Rd
Richmond, VA 23227-4307
Phone (804) 477-4210

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
0401413495VAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Dental Company, PLLC PastSince Jan 26, 2020 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": "1343520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1740536663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 STILLMAN PKWY",
            "address_2": "SUITE 101",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232331455",
            "telephone_number": "804-934-9292",
            "fax_number": "804-934-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 STILLMAN PKWY",
            "address_2": "SUITE 101",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232331455",
            "telephone_number": "804-934-9292",
            "fax_number": "804-934-9290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3404 Hermitage Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232274307",
            "country_code": "US",
            "telephone_number": "804-477-4210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BATES",
        "first_name": "SHELDON",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-29",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401413495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.