Dipti Kanchan, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN29559 Issued in FL

Practice address

1036 Dunn Ave Ste 42
Jacksonville, FL 32218-6365

Phone

(904) 714-9909

Fax

(904) 746-4286

NPI assigned

Aug 20, 2024

Last updated

Aug 20, 2024By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1336972082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 TECHNOLOGY PARK STE 101",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327467122",
            "telephone_number": "407-543-8514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 DUNN AVE STE 42",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322186365",
            "telephone_number": "904-714-9909",
            "fax_number": "904-746-4286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANCHAN",
        "first_name": "DIPTI",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN29559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan Kamperman, M.D.
• Kaitlin Kamrowski, D.O.
• Ozdemir Yusef Kanar, M.D.
• Koteswari Kancha, MD
• Ravi Kumar Kancha, MD
• Arline Jose Kandathiparampil, M.D.
• Pujan Kandel, MD
• Alexa Kane, PSYD
• Andrew John Kane, M.D.
• Chris John Kane, D.O.

• General Practice Dentistry in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.