Active NPI
Ankush Katkade
- General Practice Dentistry
- Springfield, IL
National Provider Identifier
1063179919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019.033462
- Practice address
- 2239 E Cook St
Springfield, IL 62703-1944 - Phone
- (217) 788-2300
- NPI assigned
- Nov 25, 2021
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019.033462 | IL | Primary |
Addresses
Primary practice location
2239 E Cook St
Springfield, IL 62703-1944
Mailing address
2239 E Cook St
Springfield, IL 62703-1944
Phone (217) 788-2300
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.033462 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678752000000",
"number": "1063179919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2239 E COOK ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627031944",
"telephone_number": "217-788-2300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2239 E COOK ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627031944",
"telephone_number": "217-788-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KATKADE",
"first_name": "ANKUSH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-25",
"last_updated": "2023-03-14",
"certification_date": "2023-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019.033462",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.