Keerthana Mesineni, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

10565 Issued in SC

Practice address

810 Brayden Pkwy Apt 109
Fort Mill, SC 29708-0198

Phone

(980) 322-5011

NPI assigned

Jul 3, 2023

Last updated

Jul 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1386321164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 N CALDWELL ST APT 420",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282063678",
            "telephone_number": "980-322-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 BRAYDEN PKWY APT 109",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297080198",
            "telephone_number": "980-322-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESINENI",
        "first_name": "KEERTHANA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "10565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.