Kemal Feroze Baksh, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401417547 Issued in VA

Practice address

559TH Medical Squadron
221 3Rd St W
Randolph Afb, TX 78150

Phone

(210) 652-1846

NPI assigned

Mar 22, 2021

Sex

Male

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1457937229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559TH MEDICAL SQUADRON",
            "address_2": "221 3RD STREET W",
            "city": "RANDOLPH AFB",
            "state": "TX",
            "postal_code": "78150",
            "telephone_number": "210-652-1846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559TH MEDICAL SQUADRON",
            "address_2": "221 3RD ST W",
            "city": "RANDOLPH AFB",
            "state": "TX",
            "postal_code": "78150",
            "telephone_number": "210-652-1846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKSH",
        "first_name": "KEMAL",
        "middle_name": "FEROZE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2023-08-01",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401417547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 359TH MDG
• 59TH MDW-Whasc-Lackland
• Gary Lynn Abbott, OD
• Jenara Leigh Allen, DDS
• Precious Arnette, FNP
• Allison Lynn Bradshaw, PA
• Esther Marie Bustamante, RD
• Christopher Benjamin Chappell, LCSW
• Cherry Choy, DMD
• John Christian Davis, D.D.S.

• General Practice Dentistry in Randolph Afb, TX
• Providers in Randolph Afb, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.