Individual provider Active NPI

K. S. Wendy Jangdhari, DDS

  • General Practice Dentistry
  • Nashville, TN
National Provider Identifier
1275647463
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
TN DS 4380 Issued in TN
Practice address
521 E Trinity LN
Nashville, TN 37207-4705
Phone
(615) 226-5250
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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 TN DS 4380 TN Primary

Addresses

Primary practice location

521 E Trinity LN
Nashville, TN 37207-4705

Mailing address

521 E Trinity LN
Nashville, TN 37207-4705
Phone (615) 226-5250

Other identifiers 2

IdentifierTypeStateIssuer
861883OtherTNUNITED CONCORDIA
0054816OtherTNBLUE CROSS BLUE SHIELD TN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170322001331 TN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1850676453
I20170328001112 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1850676453

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TN DS 4380TNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1275647463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 E TRINITY LN",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372074705",
            "telephone_number": "615-226-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E TRINITY LN",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372074705",
            "telephone_number": "615-226-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANGDHARI",
        "first_name": "K. S. WENDY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "TN DS 4380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "861883",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TN",
            "identifier": "0054816",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.