Individual provider Active NPI

Shital N Patel, DDS

  • Pediatric Dentistry
  • Midlothian, VA
National Provider Identifier
1972734705
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0401413587 Issued in VA
Practice address
305 Schofield Dr
Midlothian, VA 23113-7331
Phone
(804) 601-3139
Fax
(804) 451-5993
NPI assigned
Jul 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401413587 VA
Pediatric Dentistry 1223P0221X 0401413587 VA Primary

Addresses

Primary practice location

305 Schofield Dr
Midlothian, VA 23113-7331

Mailing address

305 Schofield Dr
Midlothian, VA 23113-7331
Phone (804) 601-3139

Other practice location 1

6900 Forest Ave
Suite 110
Richmond, VA 23230-1701
Phone (804) 893-8715

Other practice location 2

5801 Bremo Rd
Richmond, VA 23226-1907
Phone (804) 285-2011

Other identifiers 1

IdentifierTypeStateIssuer
C06778OtherVAGROUP PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL http://midlothianpediatricdentist.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20120918000758 VA Practitioner - Oral SurgeryPractitioner - Dentist 7315195286 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours St. Mary'S Hospital of Richmond LLC Current Accepting new patients
Bon Secours St Marys Hospital of Richmond LLC CurrentSince Sep 1, 2012 Accepting new patients
Bon Secours St Mary'S Hospital of Richmond LLC Pediatric Dentistry CurrentSince Sep 1, 2012 Accepting new patients
Bon Secours-St. Mary'S Hospital of Richmond, Inc. Past Accepting new patients

Locations

5855 Bremo Rd
Ste 306
Richmond, VA 23226
Phone (804) 287-7644

6900 Forest Ave
Ste 110
Richmond, VA 23230
Phone (804) 893-8692

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

7229 Forest Ave
Ste 112
Richmond, VA 23226
Phone (804) 281-0275

Interoperability endpoints

  • Direct secure messaging: spatel1154537@direct.bsmhealth.org

Organizations & group practices 4

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": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1972734705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 SCHOFIELD DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231137331",
            "telephone_number": "804-601-3139",
            "fax_number": "804-451-5993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 SCHOFIELD DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231137331",
            "telephone_number": "804-601-3139",
            "fax_number": "804-451-5993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6900 Forest Ave",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232301701",
            "country_code": "US",
            "telephone_number": "804-893-8715",
            "fax_number": "804-285-1292",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5801 Bremo Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232261907",
            "country_code": "US",
            "telephone_number": "804-285-2011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHITAL",
        "middle_name": "N",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413587",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401413587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06778",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "http://midlothianpediatricdentist.com",
            "affiliation": "N",
            "endpointDescription": "MCD Website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "305 Schofield Dr",
            "city": "Midlothian",
            "state": "VA",
            "country_code": "US",
            "postal_code": "231137331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.