Individual provider Active NPI

Veera Aparanji Kaja, DMD

  • General Practice Dentistry
  • Jacksonville, IL
National Provider Identifier
1205031317
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019030101 Issued in IL
Practice address
1614 W Lafayette Ave Ste 4
Jacksonville, IL 62650-3711
Phone
(217) 243-4032
Fax
(217) 718-3469
NPI assigned
Jun 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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 019030101 IL Primary

Addresses

Primary practice location

1614 W Lafayette Ave Ste 4
Jacksonville, IL 62650-3711

Mailing address

1614 W Lafayette Ave Ste 4
Jacksonville, IL 62650-3711
Phone (217) 243-4032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20150813009404 IL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 0840505376

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019030101ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1205031317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 W LAFAYETTE AVE STE 4",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503711",
            "telephone_number": "217-243-4032",
            "fax_number": "217-718-3469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 W LAFAYETTE AVE STE 4",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503711",
            "telephone_number": "217-243-4032",
            "fax_number": "217-718-3469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAJA",
        "first_name": "VEERA",
        "middle_name": "APARANJI",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019030101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, IL

Sources for this page

Verify at the official NPI Registry.