Individual provider Active NPI

Abhinav Kalra, DDS

  • Dentist
  • Mansfield, TX
National Provider Identifier
1023561933
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
38405 Issued in TX
Practice address
1811 Highway 287 N Ste 160
Mansfield, TX 76063-7571
Phone
(817) 453-1001
Fax
(817) 453-1221
NPI assigned
Jul 27, 2016
Last updated
Jul 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 38405 TX Primary
Dentist 122300000X 019030901 IL

Addresses

Primary practice location

1811 Highway 287 N Ste 160
Mansfield, TX 76063-7571

Mailing address

1811 Highway 287 N Ste 160
Mansfield, TX 76063-7571
Phone (817) 453-1001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20160808001907 IL Order and Referring Only - DentistPractitioner - Dentist 1658665047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38405TXMDClinical Psychologist
019030901ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Picasso Dental-Mansfield PLLC Dentist PastSince Jul 3, 2022 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1023561933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 HIGHWAY 287 N STE 160",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637571",
            "telephone_number": "817-453-1001",
            "fax_number": "817-453-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 HIGHWAY 287 N STE 160",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637571",
            "telephone_number": "817-453-1001",
            "fax_number": "817-453-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALRA",
        "first_name": "ABHINAV",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-27",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "38405",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019030901",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.