Individual provider Active NPI

Kavita Dave

  • Pediatric Dentistry
  • Phoenix, AZ
National Provider Identifier
1093457673
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D012237 Issued in AZ
Practice address
2533 N 75TH Ave
Phoenix, AZ 85035-1211
Phone
(845) 553-5833
NPI assigned
Apr 12, 2022
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X D012237 AZ Primary
Student in an Organized Health Care Education/Training Program 390200000X DC

Addresses

Primary practice location

2533 N 75TH Ave
Phoenix, AZ 85035-1211

Mailing address

46 Ladentown Rd
Pomona, NY 10970-2862
Phone (845) 553-5833

Other practice location 1

600 W St NW # 2005
Washington, DC 20059-1022
Phone (202) 806-6100

Other practice location 2

160 E Erie Ave
Philadelphia, PA 19134-1011
Phone (215) 427-5000

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
D012237AZMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Cute Smiles 4 Kids Past Accepting new patients
Sdcaz LLC Pediatric Dentistry PastSince Apr 6, 2025 Accepting new patients

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": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1093457673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 LADENTOWN RD",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109702862",
            "telephone_number": "845-553-5833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2533 N 75TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850351211",
            "telephone_number": "845-553-5833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 W St NW # 2005",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200591022",
            "country_code": "US",
            "telephone_number": "202-806-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 E Erie Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191341011",
            "country_code": "US",
            "telephone_number": "215-427-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVE",
        "first_name": "KAVITA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-12",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "D012237",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "DC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.