Active NPI
Smita Kumar
- General Practice Dentistry
- Racine, WI
National Provider Identifier
1295148997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7260-15
- Practice address
- 4915 Washington Ave Ste B
Racine, WI 53406-4221 - Phone
- (262) 619-1949
- Fax
- (877) 335-3684
- NPI assigned
- Jun 10, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7260-15 | WI | Primary |
Addresses
Primary practice location
4915 Washington Ave Ste B
Racine, WI 53406-4221
Mailing address
2572 S 76TH St
West Allis, WI 53219-2476
Phone (414) 306-6420
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150702000452 | WI | Order and Referring Only - Oral Surgery | 8820300932 |
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": "1402358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402358400000",
"number": "1295148997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2572 S 76TH ST",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532192476",
"telephone_number": "414-306-6420",
"fax_number": "877-335-3684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4915 WASHINGTON AVE STE B",
"city": "RACINE",
"state": "WI",
"postal_code": "534064221",
"telephone_number": "262-619-1949",
"fax_number": "877-335-3684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUMAR",
"first_name": "SMITA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-10",
"last_updated": "2014-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "7260-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Racine, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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.