Individual provider Active NPI

Shutong Zhan Akmal, DMD

  • General Practice Dentistry
  • Arlington, VA
National Provider Identifier
1851813430
Registry record updated Jul 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12014940A Issued in IN
Practice address
3400 S Clark St Ste 105
Arlington, VA 22202-4050
Phone
(703) 263-8009
Fax
(571) 263-8009
NPI assigned
Jul 14, 2017
Last updated
Jul 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DEN1001750 DC
General Practice Dentistry 1223G0001X 0401415837 VA
General Practice Dentistry 1223G0001X 12014940A IN Primary

Addresses

Primary practice location

3400 S Clark St Ste 105
Arlington, VA 22202-4050

Mailing address

3321 Treviso CV
Fort Wayne, IN 46814-8242
Phone (828) 719-5723

Other practice location 1

4616 W Jefferson Blvd
Fort Wayne, IN 46804-6826
Phone (260) 432-8414

Other names 1

  • Shutong Hartsell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170908000867 DC Order and Referring Only - DentistPractitioner - Dentist 2264705565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN1001750DCMDGeneral Practice Dentistry
12014940AINMDGeneral Practice Dentistry
0401415837VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Dental, PLLC General Practice CurrentSince Jan 26, 2022 Accepting new patients
Jungwon Roh, DDS, PLLC General Practice PastSince Jun 11, 2023 Accepting new patients
Shutong Akmal, DMD, LLC Past Accepting new patients

Locations

3400 S Clark St
Ste 105
Arlington, VA 22202
Phone (703) 263-8009

Organizations & group practices 3

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": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784937600000",
    "number": "1851813430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3321 TREVISO CV",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468148242",
            "telephone_number": "828-719-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 S CLARK ST STE 105",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222024050",
            "telephone_number": "703-263-8009",
            "fax_number": "571-263-8009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4616 W Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468046826",
            "country_code": "US",
            "telephone_number": "260-432-8414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AKMAL",
        "first_name": "SHUTONG",
        "middle_name": "ZHAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2026-07-25",
        "certification_date": "2026-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "DEN1001750",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415837",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12014940A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHUTONG",
            "last_name": "HARTSELL",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.