Individual provider Active NPI

Kanwarpal Singh, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Manchester, CT
National Provider Identifier
1083927214
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
010315 Issued in CT
Practice address
419 Middle Tpke W
Manchester, CT 06040-3833
Phone
(860) 661-4000
Fax
(860) 661-4002
NPI assigned
Jul 16, 2010
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 010315 CT
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 010315 CT Primary

Addresses

Primary practice location

419 Middle Tpke W
Manchester, CT 06040-3833

Mailing address

419 Middle Tpke W
Manchester, CT 06040-3833
Phone (860) 661-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240327000537 CT Practitioner - Oral Surgery 1355788274 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010315CTMDDentist
10315CTMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kanwarpal Singh DDS LLC Dentist CurrentSince Feb 27, 2024 Accepting new patients
Ace Dental Group CurrentSince Jan 12, 2024 Accepting new patients

Locations

419 Middle Tpke W
Manchester, CT 06040
Phone (860) 643-3598

571 Wolcott St
Wolcott, CT 06705
Phone (203) 753-9503

Organizations & group practices 2

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": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1083927214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 MIDDLE TPKE W",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403833",
            "telephone_number": "860-661-4000",
            "fax_number": "860-661-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 MIDDLE TPKE W",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403833",
            "telephone_number": "860-661-4000",
            "fax_number": "860-661-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINGH",
        "first_name": "KANWARPAL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-16",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "010315",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "010315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.