Sheetal Suryawanshi, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN18483 Issued in FL

Practice address

17735 Hunting Bow Circle
Lutz, Florida, FL 33558

Phone

(813) 995-6178

Fax

(813) 995-6179

NPI assigned

Apr 20, 2009

Last updated

Apr 21, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Advanced Dental Designs, LLC

  dba Bliss Dental Lounge

  • Dental Clinic/Center
  • Lutz, FL
  • NPI 1508486200
  NPD Authorized official
• Care Multispecialty Group LLC

  dba Care Multispeciality Group LLC

  • Primary Care Clinic/Center
  • Tampa, FL
  • NPI 1902088347
  NPD (past)

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

{
    "created_epoch": "1240185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1750524864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17735 HUNTING BOW CIRCLE",
            "city": "LUTZ, FLORIDA",
            "state": "FL",
            "postal_code": "33558",
            "telephone_number": "813-995-6178",
            "fax_number": "813-995-6179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17735 HUNTING BOW CIRCLE",
            "city": "LUTZ, FLORIDA",
            "state": "FL",
            "postal_code": "33558",
            "telephone_number": "813-995-6178",
            "fax_number": "813-995-6179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURYAWANSHI",
        "first_name": "SHEETAL",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-20",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; 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.