Individual provider Active NPI

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

  • Periodontics
  • Davie, FL
National Provider Identifier
1114207115
Registry record updated Aug 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DTP552 Issued in 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
Last updated
Aug 22, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DTP552 FL Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160120001967 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8921301235

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DTP552FLMDPeriodontist
0133NCMDAthletic Trainer

NPI Registry JSON

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

{
    "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

Sources for this page

Verify at the official NPI Registry.