Arlene Lora Nadira Kewallal, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D010584 Issued in AZ

Practice address

1520 W Warner Rd Ste 110
Gilbert, AZ 85233-7043

Phone

(615) 410-8669

NPI assigned

Mar 25, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Bluebird Pediatric Dentistry PLLC

  • Pediatric Dentistry
  • Gilbert, AZ
  • NPI 1760125504
  NPD Authorized official

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1548654791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 N CENTRAL AVE APT 3189",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 W WARNER RD STE 110",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852337043",
            "telephone_number": "615-410-8669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1935 W Happy Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850852884",
            "country_code": "US",
            "telephone_number": "623-434-0543",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Rosa L Parks Ave",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372033574",
            "country_code": "US",
            "telephone_number": "813-389-3408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Lentz Dr Ste 40",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "TN",
            "postal_code": "371155135",
            "country_code": "US",
            "telephone_number": "615-868-9057",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "118 Maple Row Blvd Ste A1",
            "address_purpose": "LOCATION",
            "city": "Hendersonville",
            "state": "TN",
            "postal_code": "37075",
            "country_code": "US",
            "telephone_number": "615-824-5047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEWALLAL",
        "first_name": "ARLENE",
        "middle_name": "LORA NADIRA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-25",
        "last_updated": "2022-04-28",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "D010584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005890",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Keys Solutions LLC (NuSerenity Wellness)
• Sharifa Khalil
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• Afzal Hussian Khan, M.D.
• Asim Khan, DO

• Pediatric Dentistry in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Pediatric Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.