Individual provider Active NPI

Krishna Dipnarine

  • Dentist
  • Effingham, IL
National Provider Identifier
1669030557
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN24186 Issued in FL
Practice address
1200 Network Centre Dr
Effingham, IL 62401-4602
Phone
(217) 540-8386
NPI assigned
Jun 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN24186 FL Primary

Addresses

Primary practice location

1200 Network Centre Dr
Effingham, IL 62401-4602

Mailing address

1200 Network Centre Dr
Effingham, IL 62401-4602
Phone (217) 540-8386

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210216000163 FL Order and Referring Only - DentistPractitioner - Dentist 1951716448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1669030557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 NETWORK CENTRE DR",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624014602",
            "telephone_number": "217-540-8386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NETWORK CENTRE DR",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624014602",
            "telephone_number": "217-540-8386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIPNARINE",
        "first_name": "KRISHNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Effingham, IL

Sources for this page

Verify at the official NPI Registry.