Individual provider Active NPI

Ankita Kakar, DDS

  • Dentist
  • Santa Rosa, CA
National Provider Identifier
1346906351
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS106876 Issued in CA
Practice address
2448 Guerneville Rd Ste 200
Santa Rosa, CA 95403-7223
Phone
(707) 579-2808
NPI assigned
Nov 14, 2021
Last updated
Nov 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS106876 CA Primary

Addresses

Primary practice location

2448 Guerneville Rd Ste 200
Santa Rosa, CA 95403-7223

Mailing address

848 Brush Creek Rd
Santa Rosa, CA 95404-2778
Phone (818) 746-5868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20221108002964 CA Order and Referring Only - DentistPractitioner - Dentist 8527435346

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS106876CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Petersen Dental Care CurrentSince Feb 9, 2025 Accepting new patients

Locations

2448 Guerneville Rd
Ste 200
Santa Rosa, CA 95403
Phone (707) 579-2808

Organizations & group practices 1

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": "1636848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1346906351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "848 BRUSH CREEK RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954042778",
            "telephone_number": "818-746-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2448 GUERNEVILLE RD STE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954037223",
            "telephone_number": "707-579-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAKAR",
        "first_name": "ANKITA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-14",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS106876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.