Sudhakar Y Shetty, D.D.S
Dentist, General Practice in Woodhaven, NY. Individual provider (NPI-1).
NPI number1861663569
StatusActive
Last updated in NPPESMar 20, 2008
Details
- NPI
- 1861663569
- Entity type
- Individual (NPI-1)
- Name
- Sudhakar Y Shetty
- Credential
- D.D.S
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 20, 2008
- Last updated
- Mar 20, 2008
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- Medicare opt-out
- Dec 8, 2015 to Dec 8, 2027
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 034912 | NY | Yes |
Practice location
8713 Jamaica AveWoodhaven, NY 11421-2037
Phone 718-847-8023 · Fax 718-847-2009
Mailing address
8713 Jamaica AveWoodhaven, NY 11421-2037
Phone 718-847-8023 · Fax 718-847-2009
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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