Individual provider Active NPI

Khushbu Kakadia

  • Dentist
  • Allentown, PA
National Provider Identifier
1659859783
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS041899 Issued in PA
Practice address
1651 N Cedar Crest Blvd Ste 206
Allentown, PA 18104-2316
Phone
(917) 794-9636
NPI assigned
Jul 31, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DS041899 PA Primary

Addresses

Primary practice location

1651 N Cedar Crest Blvd Ste 206
Allentown, PA 18104-2316

Mailing address

107 Guinness LN
North Wales, PA 19454-1234
Phone (917) 794-9636

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

LicenseStateTypeSpecialty
DS041899PAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1659859783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 GUINNESS LN",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194541234",
            "telephone_number": "917-794-9636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 N CEDAR CREST BLVD STE 206",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042316",
            "telephone_number": "917-794-9636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAKADIA",
        "first_name": "KHUSHBU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS041899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.