Krishna Anil Gheewala, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

7704 Issued in OK

Practice address

8811 E Reno Ave Ste 103
Midwest City, OK 73110-7726

Phone

(405) 732-2660

NPI assigned

May 22, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1669164364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 LAKESIDE DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731602725",
            "telephone_number": "580-743-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8811 E RENO AVE STE 103",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731107726",
            "telephone_number": "405-732-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHEEWALA",
        "first_name": "KRISHNA",
        "middle_name": "ANIL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "7704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "epicdentalok@gmail.com",
            "affiliation": "N",
            "address_1": "8811 E Reno Ave Ste 103",
            "city": "Midwest City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731107726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Dentist in Midwest City, OK
• Providers in Midwest City, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.