Individual provider Active NPI

Menaka D Chandra, DDS

  • Dentist
  • Eureka, MO
National Provider Identifier
1265528616
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2003014581 Issued in MO
Practice address
18 Hilltop Village Center Dr
Eureka, MO 63025-1189
Phone
(636) 938-6241
Fax
(636) 938-7941
NPI assigned
Oct 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2003014581 MO Primary

Addresses

Primary practice location

18 Hilltop Village Center Dr
Eureka, MO 63025-1189

Mailing address

18 Hilltop Village Center Dr
Eureka, MO 63025-1189
Phone (636) 938-6241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20170109002498 MO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8123309036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eureka Smiles Dentist Past Accepting new patients
Jack D Griffin Jr DMD PC Dentist Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265528616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 HILLTOP VILLAGE CENTER DR",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251189",
            "telephone_number": "636-938-6241",
            "fax_number": "636-938-7941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 HILLTOP VILLAGE CENTER DR",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251189",
            "telephone_number": "636-938-6241",
            "fax_number": "636-938-7941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDRA",
        "first_name": "MENAKA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2003014581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, MO

Sources for this page

Verify at the official NPI Registry.