Active NPI
Shruti Shukla, DDS
- General Practice Dentistry
- Chicago, IL
National Provider Identifier
1811159346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22216
- Practice address
- 430 W Erie St
Ste 200
Chicago, IL 60610-6914 - Phone
- (312) 274-0308
- NPI assigned
- Jun 26, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22216 | MA | Primary |
Addresses
Primary practice location
430 W Erie St
Ste 200
Chicago, IL 60610-6914
Mailing address
1307 Blueberry CT
Edison, NJ 08817-2603
Phone (732) 692-4420
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22216 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214438400000",
"number": "1811159346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1307 BLUEBERRY CT",
"city": "EDISON",
"state": "NJ",
"postal_code": "088172603",
"telephone_number": "732-692-4420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 W ERIE ST",
"address_2": "STE 200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606106914",
"telephone_number": "312-274-0308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUKLA",
"first_name": "SHRUTI",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-26",
"last_updated": "2008-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "22216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.