Individual provider Active NPI

Anjalika KC, DDS

  • Dentist
  • Chelsea, MA
National Provider Identifier
1568136331
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1859138 Issued in MA
Practice address
373 Broadway
Chelsea, MA 02150-2809
Phone
(617) 887-0600
NPI assigned
Aug 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1859138 MA Primary

Addresses

Primary practice location

373 Broadway
Chelsea, MA 02150-2809

Mailing address

2 Moreland PL
Everett, MA 02149-1406
Phone (347) 605-8051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20210920000237 MA Order and Referring Only - DentistPractitioner - Dentist 9133526197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Family Dental PC CurrentSince Oct 9, 2022 Accepting new patients
Broadway Family Dental PC PastSince Aug 8, 2021 Accepting new patients

Locations

373 Broadway
Chelsea, MA 02150
Phone (617) 887-0600

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.

NPI Registry JSON

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1568136331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MORELAND PL",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021491406",
            "telephone_number": "347-605-8051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 BROADWAY",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "021502809",
            "telephone_number": "617-887-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KC",
        "first_name": "ANJALIKA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-05",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1859138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelsea, MA

Sources for this page

Verify at the official NPI Registry.