Andrea Lynnette Shorterevans, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

0401008394 Issued in VA

Practice address

620 John Paul Jones Cir
Portsmouth, VA 23708-2111

Phone

(757) 953-7550

NPI assigned

Feb 17, 2006

Last updated

Apr 26, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1811962525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CRESTON CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233234085",
            "telephone_number": "757-513-3227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082111",
            "telephone_number": "757-953-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORTEREVANS",
        "first_name": "ANDREA",
        "middle_name": "LYNNETTE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401008394",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "11678",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Nathan Shippy, M.D.
• Jennifer Catherine Shippy, M.D.
• Paula Rinebolt Shirk, M.S., N.C.S.P.
• Timothy R Shope, MD
• Morgan Shore
• Kevin G Shortt, M.D.
• Rosa Sunny Shu, PA-C
• Michael William Shulby, DO
• Akas Siddiqui, M.D., M.P.H.
• David Lee Siddle, RPH

• Dentist in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.