Individual provider Active NPI

Krishna C Thumati, D.M.D

  • Dentist
  • Philadelphia, PA
National Provider Identifier
1669793923
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS038334 Issued in PA
Practice address
5675 N Front St
Unit 50
Philadelphia, PA 19120
Phone
(920) 838-1649
NPI assigned
Jun 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS038334 PA Primary

Addresses

Primary practice location

5675 N Front St
Unit 50
Philadelphia, PA 19120

Mailing address

35 Northampton St
Apt No 1809
Boston, MA 02118-4014
Phone (617) 429-0571

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170314000475 PA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 1153606173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS038334PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Dreams, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277078400000",
    "number": "1669793923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 NORTHAMPTON ST",
            "address_2": "APT NO 1809",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184014",
            "telephone_number": "617-429-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5675 N FRONT ST",
            "address_2": "UNIT 50",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19120",
            "telephone_number": "920-838-1649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THUMATI",
        "first_name": "KRISHNA",
        "middle_name": "C",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-21",
        "last_updated": "2010-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS038334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.