Active NPI
Kalin Jeetesh Bhavan, DDS
- General Practice Dentistry
- Wichita Falls, TX
National Provider Identifier
1639805781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 38789
- Practice address
- 2515 E Elliott St
Wichita Falls, TX 76308-3708 - Phone
- (940) 696-9702
- Fax
- (940) 691-8425
- NPI assigned
- Jul 29, 2022
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 38789 | TX | Primary |
Addresses
Primary practice location
2515 E Elliott St
Wichita Falls, TX 76308-3708
Mailing address
2529 Cima Hill Dr
Plano, TX 75025-4765
Phone (214) 562-7068
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38789 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659052800000",
"number": "1639805781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2529 CIMA HILL DR",
"city": "PLANO",
"state": "TX",
"postal_code": "750254765",
"telephone_number": "214-562-7068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2515 E ELLIOTT ST",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763083708",
"telephone_number": "940-696-9702",
"fax_number": "940-691-8425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BHAVAN",
"first_name": "KALIN",
"middle_name": "JEETESH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-29",
"last_updated": "2022-07-29",
"certification_date": "2022-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "38789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita Falls, TX
- Rachel S Bertleson, BACA, LBA, LPA - I
- Bestcare Health Services,Inc
- Bestcare Specialty Services, Inc.
- Beyondfaith Hospice of Jacksboro, LLC (BeyondFaith Hospice of Wichita Falls, LLC)
- Pranav Purushottambhai Bhanushali
- Terrell Bibb, M.D.
- Cameron Alexandra Bice, LPC ASSOCIATE
- Paul Lankford Bice, M.D.
- Conn Daniel Bickhard, D.C.
- Big Sky Counseling and Assessment
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.