Individual provider Active NPI

Shreya Patel, DDS

  • General Practice Dentistry
  • Norfolk, VA
National Provider Identifier
1992290431
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401418604 Issued in VA
Practice address
220 W Brambleton Ave Ste 110
Norfolk, VA 23510-1571
Phone
(757) 583-1536
NPI assigned
Jun 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11269 NC
General Practice Dentistry 1223G0001X 0401418604 VA Primary

Addresses

Primary practice location

220 W Brambleton Ave Ste 110
Norfolk, VA 23510-1571

Mailing address

220 W Brambleton Ave Ste 110
Norfolk, VA 23510-1571
Phone (912) 856-2193

Other practice location 1

7400 Granby St Ste D
Norfolk, VA 23505-3436
Phone (757) 583-1535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190816002122 NC Order and Referring Only - DentistPractitioner - Dentist 3779810569

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401418604VAMDGeneral Practice Dentistry
11269NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
CD Virginia Dental P.C. Dentist PastSince Dec 10, 2023 Accepting new patients

Organizations & group practices 1

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": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1992290431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W BRAMBLETON AVE STE 110",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101571",
            "telephone_number": "912-856-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W BRAMBLETON AVE STE 110",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101571",
            "telephone_number": "757-583-1536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7400 Granby St Ste D",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235053436",
            "country_code": "US",
            "telephone_number": "757-583-1535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHREYA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "11269",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401418604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.