Individual provider Active NPI

Yashri Sanghani, DMD

  • Dentist
  • Lakeland, FL
National Provider Identifier
1396317350
Registry record updated Jul 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
26092 Issued in FL
Practice address
4620 S Florida Ave Ste 120
Lakeland, FL 33813-2166
Phone
(863) 216-5765
NPI assigned
Jul 10, 2021
Last updated
Jul 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 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 26092 FL Primary

Addresses

Primary practice location

4620 S Florida Ave Ste 120
Lakeland, FL 33813-2166

Mailing address

2410 Blue Stone CT
Valrico, FL 33594-5149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210813000076 FL Order and Referring Only - DentistPractitioner - Dentist 7517361512

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26092FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Modern Dentistry, PA Dentist PastSince Jul 20, 2021 Accepting new patients

Networks

  • Freedom Health HMO Network

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": "1625875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625875200000",
    "number": "1396317350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 BLUE STONE CT",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335945149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 S FLORIDA AVE STE 120",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132166",
            "telephone_number": "863-216-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANGHANI",
        "first_name": "YASHRI",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-10",
        "last_updated": "2021-07-10",
        "certification_date": "2021-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "26092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.