Individual provider Active NPI

Kapil Laddha, D.D.S.

  • General Practice Dentistry
  • Anthony, NM
National Provider Identifier
1629513338
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
37135 Issued in TX
Practice address
855 Anthony Dr
Anthony, NM 88021
Phone
(575) 882-3607
Fax
(575) 882-2909
NPI assigned
Jan 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1001465 WI
General Practice Dentistry 1223G0001X DD4829 NM
General Practice Dentistry 1223G0001X 37135 TX Primary

Addresses

Primary practice location

855 Anthony Dr
Anthony, NM 88021

Mailing address

385 Calle de Alegra Ste a
Las Cruces, NM 88005-3423
Phone (575) 526-1105

Other identifiers 1

IdentifierTypeStateIssuer
20789840MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20170110000582 WI Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 3577844307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1001465WIMDDentist
DD4829NMMDGeneral Practice Dentistry
37135TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1629513338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 CALLE DE ALEGRA STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053423",
            "telephone_number": "575-526-1105",
            "fax_number": "575-524-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 ANTHONY DR",
            "city": "ANTHONY",
            "state": "NM",
            "postal_code": "88021",
            "telephone_number": "575-882-3607",
            "fax_number": "575-882-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADDHA",
        "first_name": "KAPIL",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-04",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001465",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD4829",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "37135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20789840",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anthony, NM

Sources for this page

Verify at the official NPI Registry.