Active NPI
Angeli Jayesh Thakker, D.D.S.
- Pediatric Dentistry
- Bellevue, NE
National Provider Identifier
1427042746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 6301
- Practice address
- 11511 S 42ND St
Bellevue, NE 68123-1026 - Phone
- (402) 291-5400
- Fax
- (402) 291-5401
- NPI assigned
- Sep 1, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 6301 | NE | Primary |
Addresses
Primary practice location
11511 S 42ND St
Bellevue, NE 68123-1026
Mailing address
11511 S 42ND St
Bellevue, NE 68123-1026
Phone (402) 291-5400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-002-526-5400 | Medicaid | NE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301 | NE | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690502400000",
"number": "1427042746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11511 S 42ND ST",
"city": "BELLEVUE",
"state": "NE",
"postal_code": "681231026",
"telephone_number": "402-291-5400",
"fax_number": "402-291-5401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11511 S 42ND ST",
"city": "BELLEVUE",
"state": "NE",
"postal_code": "681231026",
"telephone_number": "402-291-5400",
"fax_number": "402-291-5401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAKKER",
"first_name": "ANGELI",
"middle_name": "JAYESH",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-09-01",
"last_updated": "2023-07-28",
"certification_date": "2023-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NE",
"license": "6301",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1-002-526-5400",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.