Individual provider Active NPI

Karun Kaushal, DDS

  • General Practice Dentistry
  • Fairfield, CA
National Provider Identifier
1245876051
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
104558 Issued in CA
Practice address
2432 Mainsail CT
Fairfield, CA 94534-1784
Phone
(707) 389-0702
NPI assigned
Nov 27, 2019
Last updated
Nov 27, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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 104558 CA Primary

Addresses

Primary practice location

2432 Mainsail CT
Fairfield, CA 94534-1784

Mailing address

2432 Mainsail CT
Fairfield, CA 94534-1784
Phone (707) 389-0702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20241030004362 CA Order and Referring Only - DentistPractitioner - Dentist 6406389303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1245876051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2432 MAINSAIL CT",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945341784",
            "telephone_number": "707-389-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2432 MAINSAIL CT",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945341784",
            "telephone_number": "707-389-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUSHAL",
        "first_name": "KARUN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-27",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.