Kekul Bharucha, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02905200 Issued in NJ

Practice address

2 Split Rock Dr Ste 10
Cherry Hill, NJ 08003-1244

Phone

(856) 724-5220

NPI assigned

Jul 19, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bespoke Smiles

  • Dental Clinic/Center
  • Marlton, NJ
  • NPI 1063305712
  NPD Authorized official
• Main Street Dental - Mullica Hill

  • General Practice Dentistry
  • Mullica Hill, NJ
  • NPI 1295264521
  NPD (past)

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1164075008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SPLIT ROCK DR STE 10",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031244",
            "telephone_number": "856-724-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SPLIT ROCK DR STE 10",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031244",
            "telephone_number": "856-724-5220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Wheatley Blvd",
            "address_purpose": "LOCATION",
            "city": "Mullica Hill",
            "state": "NJ",
            "postal_code": "080629622",
            "country_code": "US",
            "telephone_number": "856-223-0041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHARUCHA",
        "first_name": "KEKUL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS042390",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02905200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Betlow
• Constance Maria Bevacqua, OT
• Laura Kaitlyn Bevil, M.ED., BCBA
• Rena S. Beyer, MSW, LCSW
• Shruti Bhalerao
• Alaukik Bhasin, DO
• Nidhi Bhatia, DD.S
• Katherine Bhojwani, PT, DPT
• David Bi
• Bert Michael Bieler, M.D.

• General Practice Dentistry in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.