Shyam Prasad Aravindaksha, BDS, MDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

2901020544 Issued in MI

Practice address

29427 Ryan Rd
Warren, MI 48092-2203

Phone

(586) 755-9340

Fax

(586) 755-9341

NPI assigned

Jun 3, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 1, 2025 through May 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1902065014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29427 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922203",
            "telephone_number": "586-755-9340",
            "fax_number": "586-755-9341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29427 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922203",
            "telephone_number": "586-755-9340",
            "fax_number": "586-755-9341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1365 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221013",
            "country_code": "US",
            "telephone_number": "404-778-4500",
            "fax_number": "404-778-5879",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARAVINDAKSHA",
        "first_name": "SHYAM PRASAD",
        "name_prefix": "Dr.",
        "credential": "BDS, MDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MI",
            "license": "2901020544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Scott Apsey, DDS
• Aquarius Home Care, LLC
• Amanda Grace Aquino-Almacen, M.D.
• Seyed Sadegh Arab, DPM
• Husain Arastu, MD
• Hussain Arbab, BDS
• Sarah Arbogast
• Franka Arcangeli, LMSW
• Aleksandr Archiyan, DO
• Alexander Arevalo, LLMSW

• Oral & Maxillofacial Surgery (D.M.D.) in Warren, MI
• Providers in Warren, MI by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.