Krishnakamal C Mehta, BDS

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

10953 Issued in FL

Practice address

3641 Connally Dr
Marianna, FL 32446-7972

Phone

(321) 634-6392

NPI assigned

Aug 25, 2006

Sex

Male

Sole proprietor

No

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 FL

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

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1275640963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3655 WEBB RD",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324468047",
            "telephone_number": "915-235-1178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3641 CONNALLY DR",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324467972",
            "telephone_number": "321-634-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "KRISHNAKAMAL",
        "middle_name": "C",
        "credential": "BDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "FL",
            "license": "10953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa McDonald
• Tamera McGlamory, LMHC
• Theresa Stone McKeithan, PHARMACIST
• Stephen Tracy Mears, ARNP
• Mefl, LLC
• Brittany Lynne Melville, APRN
• Mary Elizabeth Melvin, M.D.
• Mid-South Home Care Services, Inc.
• Deborah Milam, P.A.
• Megan C Milton, ARNP

• Public Health Dentistry in Marianna, FL
• Providers in Marianna, FL by specialty
• Public Health Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; 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.