Individual provider Active NPI

Anishwar Rohanlal Bhagwandass, DMD

  • Dentist
  • Roanoke Rapids, NC
National Provider Identifier
1609975093
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5794 Issued in NC
Practice address
50 Anna Louise LN
Roanoke Rapids, NC 27870-8648
Phone
(252) 537-4141
Fax
(252) 537-7520
NPI assigned
Sep 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5794 NC Primary

Addresses

Primary practice location

50 Anna Louise LN
Roanoke Rapids, NC 27870-8648

Mailing address

101 Mayflower CT
Roanoke Rapids, NC 27870-2243
Phone (252) 537-4141

Other identifiers 1

IdentifierTypeStateIssuer
8990719MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20151013002185 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9739498726

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5794NCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
A.R.Bhagwandass.DMD.PA Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609975093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MAYFLOWER CT",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278702243",
            "telephone_number": "252-537-4141",
            "fax_number": "252-537-7520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ANNA LOUISE LN",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278708648",
            "telephone_number": "252-537-4141",
            "fax_number": "252-537-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAGWANDASS",
        "first_name": "ANISHWAR",
        "middle_name": "ROHANLAL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "5794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8990719",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke Rapids, NC

Sources for this page

Verify at the official NPI Registry.