Individual provider Active NPI

Sheetal Rahul Manmode, DDS

  • Dentist
  • Longwood, FL
National Provider Identifier
1750811410
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN28518 Issued in FL
Practice address
1250 W State Road 434 Ste 1008
Longwood, FL 32750-4969
Phone
(407) 830-4401
NPI assigned
Jun 15, 2017
Last updated
May 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1857611 MA
Dentist 122300000X DEN03364 RI
Dentist 122300000X DN28518 FL Primary

Addresses

Primary practice location

1250 W State Road 434 Ste 1008
Longwood, FL 32750-4969

Mailing address

1250 W State Road 434 Ste 1008
Longwood, FL 32750-4969
Phone (407) 830-4401

Other names 1

  • Shital Vasant Patil Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN28518FLMDDentist
DEN03364RIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Longwood Dental PLLC CurrentSince Apr 4, 2024 Accepting new patients
Dental World Inc PastSince May 11, 2025 Accepting new patients

Locations

1250 W State Road 434
Ste 1008
Longwood, FL 32750
Phone (407) 830-4401

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": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1750811410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W STATE ROAD 434 STE 1008",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504969",
            "telephone_number": "407-830-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 W STATE ROAD 434 STE 1008",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504969",
            "telephone_number": "407-830-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANMODE",
        "first_name": "SHEETAL",
        "middle_name": "RAHUL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1857611",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "RI",
            "license": "DEN03364",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN28518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHITAL",
            "last_name": "PATIL",
            "middle_name": "VASANT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Longwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.