Active NPI
Dheepa Jagadeesan, D.D.S
- Dentist
- Dallas, TX
National Provider Identifier
1669660536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 56141
- Practice address
- 3010 LBJ Fwy
Suite 200
Dallas, TX 75234-7770 - Phone
- (424) 247-8708
- NPI assigned
- Oct 4, 2007
- Last updated
- Feb 1, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 56141 | CA | Primary |
Addresses
Primary practice location
3010 LBJ Fwy
Suite 200
Dallas, TX 75234-7770
Mailing address
7936 N Macarthur Blvd
Apt 1129
Irving, TX 75063-3742
Phone (424) 247-8708
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150611000288 | TX | Order and Referring Only - Dentist | 3375864770 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296518400000",
"number": "1669660536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7936 N MACARTHUR BLVD",
"address_2": "APT 1129",
"city": "IRVING",
"state": "TX",
"postal_code": "750633742",
"telephone_number": "424-247-8708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3010 LBJ FWY",
"address_2": "SUITE 200",
"city": "DALLAS",
"state": "TX",
"postal_code": "752347770",
"telephone_number": "424-247-8708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAGADEESAN",
"first_name": "DHEEPA",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-04",
"last_updated": "2011-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "56141",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.