Ankita Agarwal

Individual provider Active NPI Dentist · Fremont, CA

NPI 1225403199 · NPPES record last updated Dec 3, 2015

Key facts

NPI
1225403199
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
64598 (CA)
Practice address
1895 Mowry Ave
Suite 103
Fremont, CA 94538-1737
Phone
(510) 314-1475
NPI assigned
Dec 3, 2015
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20211025001192 CA Order and Referring Only - Dentist
Practitioner - Dentist
3577951565

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Aka Dental Inc Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 64598 CA Yes

Addresses

Primary practice location

1895 Mowry Ave
Suite 103
Fremont, CA 94538-1737

Mailing address

1895 Mowry Ave
Suite 103
Fremont, CA 94538-1737
Phone (510) 314-1475

Other providers in Fremont, CA

All providers in Fremont, CA · Dentist in California

Sources for this page

Verify at the official NPI Registry.