Individual provider Active NPI

Manisha Shrestha, DMD

  • Dentist
  • Annandale, VA
National Provider Identifier
1942640792
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401415519 Issued in VA
Practice address
4322 Ravensworth Rd
Annandale, VA 22003-5630
Phone
(703) 256-5870
NPI assigned
Jun 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN 20226 FL
Dentist 122300000X 0401415519 VA Primary

Addresses

Primary practice location

4322 Ravensworth Rd
Annandale, VA 22003-5630

Mailing address

4322 Ravensworth Rd
Annandale, VA 22003-5630
Phone (703) 256-5870

Other practice location 1

4322 Ravensworth Rd
Annandale, VA 22003
Phone (703) 256-5870

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 20226FLMDDentist
0401415519VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Steven R. Johnson, D.D.S. PC PastSince Nov 9, 2021 Accepting new patients
John D Dos Passos II DMD PA Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1942640792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4322 RAVENSWORTH RD",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220035630",
            "telephone_number": "703-256-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4322 RAVENSWORTH RD",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220035630",
            "telephone_number": "703-256-5870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4322 Ravensworth Rd",
            "address_purpose": "LOCATION",
            "city": "Annandale",
            "state": "VA",
            "postal_code": "22003",
            "country_code": "US",
            "telephone_number": "703-256-5870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHRESTHA",
        "first_name": "MANISHA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 20226",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401415519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.