Preetha P Kanjirath, BDS MDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901017325 Issued in MI

Practice address

1011 N University Ave
Ann Arbor, MI 48109-1078

Phone

(734) 764-1543

Fax

(734) 764-2469

NPI assigned

Mar 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368057600000",
    "number": "1366576118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 N UNIVERSITY AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091078",
            "telephone_number": "734-764-1543",
            "fax_number": "734-764-2469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N UNIVERSITY AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091078",
            "telephone_number": "734-764-1543",
            "fax_number": "734-764-2469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANJIRATH",
        "first_name": "PREETHA",
        "middle_name": "P",
        "credential": "BDS MDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2013-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901017325",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901017325",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI MED SURGICAL",
            "identifier": "1958111510",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI DENTAL",
            "identifier": "D173250",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Irene Kang
• Jin Kook Kang, MD
• Yoosang Terry Kang, MD
• Riley Kangas, CTRS
• Kirsten Neudoerffer Kangelaris, MD
• Mounika Kanneganti, MD
• Erica Anne Kanny
• Gomati Kanpahde, PT
• Michele Kantola, NP
• Nicole Marie Kantola

• Dentist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; 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.