Individual provider Active NPI

Deepanshu Bhardwaj, DDS

  • Dentist
  • Lansing, MI
National Provider Identifier
1235624073
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901022722 Issued in MI
Practice address
5601 S Cedar St
Lansing, MI 48911
Phone
(248) 974-0812
NPI assigned
Jun 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901022722 MI Primary

Addresses

Primary practice location

5601 S Cedar St
Lansing, MI 48911

Mailing address

24117 Wintergreen Circle
Novi, MI 48374
Phone (248) 974-0812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20180816003180 MI Order and Referring Only - DentistPractitioner - Dentist 2567711013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901022722MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rad Dental PLLC Current Accepting new patients
Dam Family Dental, PLLC Current Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1235624073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24117 WINTERGREEN CIRCLE",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "48374",
            "telephone_number": "248-974-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 S CEDAR ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48911",
            "telephone_number": "248-974-0812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHARDWAJ",
        "first_name": "DEEPANSHU",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901022722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.