Akshay Aswatha Kumarswamy, B.D.S , M.S – Periodontics

Key facts

NPI: 1114207115
Entity type: Individual (NPI type 1)
Primary specialty: Periodontics 1223P0300X
License: DTP552 (FL)
Practice address: 3200 S University Dr RM 7332
Davie, FL 33328-2018
Phone: (954) 262-7357
Fax: (954) 262-1782
NPI assigned: Aug 22, 2011
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NC
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20160120001967	NC	Order and Referring Only - Oral Surgery Practitioner - Oral Surgery	8921301235

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Master of Science

State licenses

License	State	Type	Specialty
DTP552	FL	MD	Periodontist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Periodontics	1223P0300X	DTP552	FL	Yes

Addresses

Primary practice location

3200 S University Dr RM 7332
Davie, FL 33328-2018

Mailing address

3200 S University Dr RM 7332
Davie, FL 33328-2018
Phone (954) 262-7357

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2011.

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313971200000",
    "number": "1114207115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR RM 7332",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-7357",
            "fax_number": "954-262-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR RM 7332",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-7357",
            "fax_number": "954-262-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMARSWAMY",
        "first_name": "AKSHAY",
        "middle_name": "ASWATHA",
        "credential": "B.D.S , M.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-22",
        "last_updated": "2011-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DTP552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

All providers in Davie, FL · Periodontics in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.