Amith Kula Shetty, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12375 Issued in MN

Practice address

13899 Highway 13 South Frontage Rd
Savage, MN 55378

Phone

(952) 440-2292

Fax

(952) 440-2935

NPI assigned

Sep 21, 2007

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Deerwood Dental, Inc

  • Clinic/Center
  • Deerwood, MN
  • NPI 1730262585
  NPD (past)
• Northland Smiles Corporation PA

  • Clinic/Center
  • Deerwood, MN
  • NPI 1043567357
  NPD (past)

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1992991004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13899 HIGHWAY 13 SOUTH FRONTAGE RD",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "55378",
            "telephone_number": "952-440-2292",
            "fax_number": "952-440-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13899 HIGHWAY 13 SOUTH FRONTAGE RD",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "55378",
            "telephone_number": "952-440-2292",
            "fax_number": "952-440-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETTY",
        "first_name": "AMITH",
        "middle_name": "KULA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-21",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Amber Seykora, LMFT
• Shaay Home Care LLC
• Aleksey Igorevich Shapoval, RN
• William Shaw, LMFT
• Monica Viola Sherman
• Micaela D Shockley, LPC
• Shoptikal LLC
• Cody John Simpson, DC
• Surjit Singh, DDS
• Brenda Sue Siolo, ANP

• General Practice Dentistry in Savage, MN
• Providers in Savage, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.