Active NPI
Egao PLLC
- General Practice Dentistry
- Jacksonville, FL
National Provider Identifier
1760214530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- EGAO PLLC
- Practice address
- 1550 Riverside Ave
Jacksonville, FL 32204-4161 - Phone
- (518) 466-4294
- NPI assigned
- Aug 19, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jasmine Shakya, DDS
- Title
- Dentist/Owner
- Phone
- (518) 466-4294
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | |||
| Endodontics | 1223E0200X | |||
| General Practice Dentistry | 1223G0001X | Primary | ||
| Oral and Maxillofacial Pathology Dentistry | 1223P0106X | |||
| Periodontics | 1223P0300X | |||
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X |
Addresses
Primary practice location
1550 Riverside Ave
Jacksonville, FL 32204-4161
Mailing address
1550 Riverside Ave
Jacksonville, FL 32204-4161
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dentist
- Albuquerque, NM
- NPI 1528435971
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724025600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1724025600000",
"number": "1760214530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1550 RIVERSIDE AVE",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322044161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1550 RIVERSIDE AVE",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322044161",
"telephone_number": "518-466-4294"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EGAO PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-08-19",
"last_updated": "2024-08-19",
"certification_date": "2024-08-19",
"status": "A",
"authorized_official_last_name": "SHAKYA",
"authorized_official_first_name": "JASMINE",
"authorized_official_title_or_position": "DENTIST/OWNER",
"authorized_official_telephone_number": "518-466-4294",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Endodontics",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
},
{
"code": "1223P0106X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Oral and Maxillofacial Pathology",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Periodontics",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.