Active NPI
Kalyan Katta, DDS
- Dentist
- Springfield, MA
National Provider Identifier
1619317849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN1856342
- Practice address
- 1049 Main Street
Springfield, MA 01103 - Phone
- (413) 304-4606
- Fax
- (413) 737-3608
- NPI assigned
- Jul 2, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN1856342 | MA | Primary |
Addresses
Primary practice location
1049 Main Street
Springfield, MA 01103
Mailing address
1049 Main Street
Springfield, MA 01103
Phone (413) 304-4606
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110028120 | Medicaid | MA |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446508800000",
"number": "1619317849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1049 MAIN STREET",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "01103",
"telephone_number": "413-304-4606",
"fax_number": "413-737-3608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1049 MAIN STREET",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "01103",
"telephone_number": "413-304-4606",
"fax_number": "413-737-3608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KATTA",
"first_name": "KALYAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-07-02",
"last_updated": "2015-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN1856342",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110028120",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.