Individual provider Active NPI

Nina S Khedkar, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Fort Worth, TX
National Provider Identifier
1043465925
Registry record updated Nov 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
0024325 Issued in TX
Practice address
5500 Overton Ridge Blvd
Suite 228
Fort Worth, TX 76132-3281
Phone
(972) 578-7800
NPI assigned
Nov 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 0024325 TX Primary

Addresses

Primary practice location

5500 Overton Ridge Blvd
Suite 228
Fort Worth, TX 76132-3281

Mailing address

840 Central Pkwy E
Suite 100
Plano, TX 75074-5551
Phone (972) 633-2775

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

State licenses

LicenseStateTypeSpecialty
0024325TXMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Charles River Orthodontics, PLLC Orthodontics and Dentofacial Orthopedics Current Accepting new patients
Scott Law Ortho Corp, PC Orthodontics and Dentofacial Orthopedics Past Accepting new patients
Packard Orthodontics PA Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227052800000",
    "number": "1043465925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 CENTRAL PKWY E",
            "address_2": "SUITE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750745551",
            "telephone_number": "972-633-2775",
            "fax_number": "469-361-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 OVERTON RIDGE BLVD",
            "address_2": "SUITE 228",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323281",
            "telephone_number": "972-578-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHEDKAR",
        "first_name": "NINA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-19",
        "last_updated": "2008-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "0024325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.