Individual provider Active NPI

Sambhavita Rangrass, D.D.S.

  • General Practice Dentistry
  • Kalamazoo, MI
National Provider Identifier
1154335057
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901017951 Issued in MI
Practice address
1719 E G Ave
Kalamazoo, MI 49004-1703
Phone
(269) 382-5327
Fax
(269) 382-2129
NPI assigned
Jul 28, 2006
Last updated
Jun 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901017951 MI Primary

Addresses

Primary practice location

1719 E G Ave
Kalamazoo, MI 49004-1703

Mailing address

1719 E G Ave
Kalamazoo, MI 49004-1703
Phone (269) 382-5327

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160817002181 MI Order and Referring Only - DentistPractitioner - Dentist 6800181777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
S. Rangrass DDS PC CurrentSince May 8, 2022 Accepting new patients
George L. Namay, D.D.S. Forest Dental, Mi PLLC General Practice PastSince Jun 23, 2024 Accepting new patients

Locations

1719 E G Ave
Kalamazoo, MI 49004
Phone (269) 382-5327

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1154335057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 E G AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490041703",
            "telephone_number": "269-382-5327",
            "fax_number": "269-382-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 E G AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490041703",
            "telephone_number": "269-382-5327",
            "fax_number": "269-382-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANGRASS",
        "first_name": "SAMBHAVITA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901017951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.