Individual provider Active NPI

Aditya Nikhil Pandya, DMD, MPH

  • Dentist
  • Glendale, AZ
National Provider Identifier
1639561145
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9424 Issued in AZ
Practice address
6120 W Bell Rd
Suite #190
Glendale, AZ 85308-3781
Phone
(602) 978-0338
NPI assigned
Feb 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9424 AZ Primary

Addresses

Primary practice location

6120 W Bell Rd
Suite #190
Glendale, AZ 85308-3781

Mailing address

2668 S Stuart Ave
Gilbert, AZ 85295-2375
Phone (651) 269-6978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170406003014 TX Practitioner - Dentist 3779886635 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9424AZMDDentist
64359CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
San Carlos Apache Healthcare Corporation Current Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince Feb 22, 2017 Accepting new patients

Locations

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

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": "1424476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1639561145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2668 S STUART AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852952375",
            "telephone_number": "651-269-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 W BELL RD",
            "address_2": "SUITE #190",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083781",
            "telephone_number": "602-978-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDYA",
        "first_name": "ADITYA",
        "middle_name": "NIKHIL",
        "name_prefix": "Dr.",
        "credential": "DMD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-21",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "9424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.