Active NPI
Rahim Bhanji, D.M.D.
- General Practice Dentistry
- Lakeland, FL
National Provider Identifier
1164642153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN0014530
- Practice address
- 215 Imperial Blvd
Suite C-2
Lakeland, FL 33803-4689 - Phone
- (863) 619-8836
- Fax
- (863) 607-9099
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN0014530 | FL | Primary |
Addresses
Primary practice location
215 Imperial Blvd
Suite C-2
Lakeland, FL 33803-4689
Mailing address
215 Imperial Blvd
Suite C-2
Lakeland, FL 33803-4689
Phone (863) 585-3256
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41199 | Other | ADI HEALTHYKIDS | |
| 183897 | Other | COMPD. HEALTHYKIDS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN0014530 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spring Lake Dental | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Winter Haven, FL
- NPI 1134322431
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281312000000",
"number": "1164642153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 IMPERIAL BLVD",
"address_2": "SUITE C-2",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338034689",
"telephone_number": "863-585-3256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 IMPERIAL BLVD",
"address_2": "SUITE C-2",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338034689",
"telephone_number": "863-619-8836",
"fax_number": "863-607-9099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BHANJI",
"first_name": "RAHIM",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2010-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN0014530",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADI HEALTHYKIDS",
"identifier": "41199",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPD. HEALTHYKIDS",
"identifier": "183897",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.