John George Kakales, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

255390 Issued in MS

Practice address

730 Goodman Rd E
Suite a
Southaven, MS 38671-9530

Phone

(662) 349-2351

Fax

(662) 349-2416

NPI assigned

May 21, 2008

Last updated

May 21, 2008By the provider in NPPES

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

Enrolled in MS

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

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• De Soto Smiles Family Dentistry

  • General Practice Dentistry
  • Southaven, MS
  • NPI 1518093962
  NPD (past) Authorized official

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1225295744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 GOODMAN RD E",
            "address_2": "SUITE A",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719530",
            "telephone_number": "662-349-2351",
            "fax_number": "662-349-2416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 GOODMAN RD E",
            "address_2": "SUITE A",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719530",
            "telephone_number": "662-349-2351",
            "fax_number": "662-349-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAKALES",
        "first_name": "JOHN",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "255390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Journey to New Beginnings, PLLC
• Journeypure Mississippi Medical Group LLC
• Journeypure Southaven, LLC
• Journeypure Southaven, LLC
• Kacey S. Joyner, ATC
• Tracy Elizabeth Kammerer
• Rebecca Kane, BCBA
• Joshua Kaplan, CADC II (COUNSELOR)
• Kara Clinellc (Rainbow Steps)
• Lela Brianne Kattawar, FNP

• General Practice Dentistry in Southaven, MS
• Providers in Southaven, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.