Active NPI
Pranab K Dutt, DDS
- Dentist
- El Centro, CA
National Provider Identifier
1023082492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 39788
- Practice address
- 1540 S Imperial Ave
El Centro, CA 92243 - Phone
- (760) 352-2773
- Fax
- (760) 352-6711
- NPI assigned
- Feb 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 39788 | CA | Primary |
Addresses
Primary practice location
1540 S Imperial Ave
El Centro, CA 92243
Mailing address
1540 S Imperial Ave
El Centro, CA 92243
Phone (760) 352-2773
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B3978801 | Other | MEDI CAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pranab K. Dutt D.D.S., a.P.C. | Past | 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.
-
- Dental Clinic/Center
- El Centro, CA
- NPI 1649512476
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023082492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1540 S IMPERIAL AVE",
"city": "EL CENTRO",
"state": "CA",
"postal_code": "92243",
"telephone_number": "760-352-2773",
"fax_number": "760-352-6711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1540 S IMPERIAL AVE",
"city": "EL CENTRO",
"state": "CA",
"postal_code": "92243",
"telephone_number": "760-352-2773",
"fax_number": "760-352-6711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUTT",
"first_name": "PRANAB",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "39788",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI CAL",
"identifier": "B3978801",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in El Centro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.