Radhika Thakkar, BDS, MPH

Primary specialty

DentistTaxonomy code 122300000X

License

063976 Issued in NY

Practice address

625 Elmwood Ave
Rochester, NY 14620-2913

Phone

(585) 275-5051

NPI assigned

May 30, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Dr. Radhika Rameshbhai Thakkar Other name

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1508559303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 WEBSTER MANOR DR APT 4",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145802011",
            "telephone_number": "201-289-3974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202913",
            "telephone_number": "585-275-5051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Webster Manor Dr Apt 4",
            "address_purpose": "LOCATION",
            "city": "Webster",
            "state": "NY",
            "postal_code": "145802011",
            "country_code": "US",
            "telephone_number": "201-289-3974",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "632 N Winton Rd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146097858",
            "country_code": "US",
            "telephone_number": "585-342-7902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAKKAR",
        "first_name": "RADHIKA",
        "name_prefix": "Dr.",
        "credential": "BDS, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-30",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "063976",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "063976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY DENTIST LICENSE",
            "identifier": "063976",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RADHIKA",
            "last_name": "THAKKAR",
            "middle_name": "RAMESHBHAI",
            "prefix": "DR.",
            "credential": "BDS, MPH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Shivender K Thakur
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• Dentist in Rochester, NY
• Providers in Rochester, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.