Individual provider Active NPI

Ashutosh Shrivastava, DMD

  • Dentist
  • Mexico, MO
National Provider Identifier
1881982833
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2015010832 Issued in MO
Practice address
340 Kelley Pkwy
Mexico, MO 65265-3811
Phone
(573) 582-1234
NPI assigned
Jul 12, 2011
Last updated
Mar 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2015010832 MO Primary

Addresses

Primary practice location

340 Kelley Pkwy
Mexico, MO 65265-3811

Mailing address

340 Kelley Pkwy
Mexico, MO 65265-3811
Phone (573) 582-1234

Other practice location 1

1225 Aguilar Dr
Montgomery City, MO 63361-2723
Phone (573) 582-1234

Other identifiers 1

IdentifierTypeStateIssuer
400157835MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250618001412 MO Practitioner - Dentist 1254621618 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
East Central Missouri Behavioral Health Services, Inc CurrentSince Jun 2, 2025 Accepting new patients
East Central Missouri Behavioral Health Services, Inc CurrentSince Jun 2, 2025 Accepting new patients
Alex Sharifian DDS Ofallon Modern Dentistry PC Past Accepting new patients
Dental Services of Troy PC Past Accepting new patients
Nexus Dental PastSince Jan 26, 2020 Accepting new patients

Locations

340 Kelley Pkwy
Mexico, MO 65265
Phone 5735821234 ext. 3017

1225 Aguilar Dr
Montgomery City, MO 63361
Phone (573) 574-1999

Interoperability endpoints

  • Direct secure messaging: ashutosh.shrivastava.p1@direct.arthurcenter.nextgenshare.com

Organizations & group practices 5

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": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1881982833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 KELLEY PKWY",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652653811",
            "telephone_number": "573-582-1234",
            "fax_number": "573-582-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 KELLEY PKWY",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652653811",
            "telephone_number": "573-582-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 Aguilar Dr",
            "address_purpose": "LOCATION",
            "city": "Montgomery City",
            "state": "MO",
            "postal_code": "633612723",
            "country_code": "US",
            "telephone_number": "573-582-1234",
            "fax_number": "573-582-1212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHRIVASTAVA",
        "first_name": "ASHUTOSH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-12",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2015010832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400157835",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mexico, MO

Sources for this page

Verify at the official NPI Registry.