Healthcare Provider Details

I. General information

NPI: 1568022846
Provider Name (Legal Business Name): SHWETA KOKATE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2019
Last Update Date: 07/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3946 MINNESOTA AVE NE
WASHINGTON DC
20019-2661
US

IV. Provider business mailing address

2221 E BIJOU ST STE 100
COLORADO SPRINGS CO
80909-8009
US

V. Phone/Fax

Practice location:
  • Phone: 202-397-1033
  • Fax: 202-397-2104
Mailing address:
  • Phone: 719-576-1850
  • Fax: 719-576-1850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN1002022
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN1002022
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: