Manu Dave Kacker, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

41738 Issued in CA

Practice address

28040 Dorothy Dr
Suite 103
Agoura Hills, CA 91301-4914

Phone

(818) 889-7779

Fax

(818) 889-2253

NPI assigned

Mar 26, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124146402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28040 DOROTHY DR",
            "address_2": "SUITE 103",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014914",
            "telephone_number": "818-889-7779",
            "fax_number": "818-889-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28040 DOROTHY DR",
            "address_2": "SUITE 103",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014914",
            "telephone_number": "818-889-7779",
            "fax_number": "818-889-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACKER",
        "first_name": "MANU",
        "middle_name": "DAVE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "41738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Jones, LMFT
• Dennis Roger Jorge, O.D.
• Joshua Jacobson MD, Inc
• Judith S. Pabst, D.D.S.,Inc. and Shohreh Selki, D.D.S. a Partnership
• Jun Park, M.D. Inc.
• Neda Kalali, PHARM.D., MHSA
• Alicia Kaleski, LMFT
• Kambic Smith, Partners
• Kanan Health Services Inc
• Emily Kane

• Dentist in Agoura Hills, CA
• Providers in Agoura Hills, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.