Individual provider Active NPI

Anjali Patel Brahmbhatt, DDS

  • Dentist
  • Horn Lake, MS
National Provider Identifier
1508533654
Registry record updated Aug 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4323-22 Issued in MS
Practice address
2154 Goodman Rd W
Horn Lake, MS 38637-1303
Phone
(662) 393-9200
Fax
(662) 393-9895
NPI assigned
Aug 26, 2021
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4323-22MSMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Happy Smiles LLC Past Accepting new patients
Ballance & Derose DDS PA Past
since Aug 29, 2021
Accepting new patients

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 13304 TN
Dentist 122300000X 4323-22 MS Primary

Addresses

NPPES NPI Registry

Primary practice location

2154 Goodman Rd W
Horn Lake, MS 38637-1303

Mailing address

945 Lower Bridge Dr Apt 8
Fayetteville, NC 28303-0842

Other practice location 1

705 Gate Ln Ste 101
Knoxville, TN 37909-3519
Phone (865) 327-1653

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2026.

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787356800000",
    "number": "1508533654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 LOWER BRIDGE DR APT 8",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283030842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2154 GOODMAN RD W",
            "city": "HORN LAKE",
            "state": "MS",
            "postal_code": "386371303",
            "telephone_number": "662-393-9200",
            "fax_number": "662-393-9895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 Gate Ln Ste 101",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379093519",
            "country_code": "US",
            "telephone_number": "865-327-1653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAHMBHATT",
        "first_name": "ANJALI",
        "middle_name": "PATEL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2026-08-22",
        "certification_date": "2026-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TN",
            "license": "13304",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "4323-22",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Horn Lake, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2026; 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.