Individual provider Active NPI

Eswar Kandaswamy

  • Periodontics
  • New Orleans, LA
National Provider Identifier
1639690332
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
P189 Issued in LA
Practice address
1100 Florida Ave
New Orleans, LA 70119-2715
Phone
(614) 477-0817
NPI assigned
Jul 3, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X P189 LA Primary

Addresses

Primary practice location

1100 Florida Ave
New Orleans, LA 70119-2715

Mailing address

1100 Florida Ave
New Orleans, LA 70119-2715
Phone (614) 477-0817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20170925002132 OH Order and Referring Only - DentistPractitioner - Dentist 4183998404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P189LAMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1639690332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 FLORIDA AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701192715",
            "telephone_number": "614-477-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 FLORIDA AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701192715",
            "telephone_number": "614-477-0817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANDASWAMY",
        "first_name": "ESWAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-03",
        "last_updated": "2022-07-21",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "LA",
            "license": "P189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.