Active NPI
Krupa Bambal
- Prosthodontics
- Glen Mills, PA
National Provider Identifier
1528785250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 2901601536
- Practice address
- 1402 Ellis Dr Apt 1402
Glen Mills, PA 19342-3403 - Phone
- (484) 714-5261
- NPI assigned
- Oct 24, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 2901601536 | MI | Primary |
Addresses
Primary practice location
1402 Ellis Dr Apt 1402
Glen Mills, PA 19342-3403
Mailing address
225 Wilmington W Chester Pike Ste 100
Chadds Ford, PA 19317-9011
Phone (427) 148-4285
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 |
|---|---|---|---|
| 2901601536 | MI | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733788800000",
"number": "1528785250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 WILMINGTON W CHESTER PIKE STE 100",
"city": "CHADDS FORD",
"state": "PA",
"postal_code": "193179011",
"telephone_number": "427-148-4285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1402 ELLIS DR APT 1402",
"city": "GLEN MILLS",
"state": "PA",
"postal_code": "193423403",
"telephone_number": "484-714-5261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAMBAL",
"first_name": "KRUPA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-24",
"last_updated": "2024-12-10",
"certification_date": "2024-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "MI",
"license": "2901601536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Mills, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.