Active NPI
Laks Jagnandan, DDS
- General Practice Dentistry
- Ankeny, IA
National Provider Identifier
1679628606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6278
- Practice address
- 2302 W 1St St
Ankeny, IA 50023-5106 - Phone
- (515) 964-8350
- Fax
- (515) 964-9519
- NPI assigned
- Jan 23, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6278 | IA | Primary |
Addresses
Primary practice location
2302 W 1St St
Ankeny, IA 50023-5106
Mailing address
2302 W 1St St
Ankeny, IA 50023-5106
Phone (515) 964-8350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0143644 | Medicaid | IA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6278 | IA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679628606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2302 W 1ST ST",
"city": "ANKENY",
"state": "IA",
"postal_code": "500235106",
"telephone_number": "515-964-8350",
"fax_number": "515-964-9519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2302 W 1ST ST",
"city": "ANKENY",
"state": "IA",
"postal_code": "500235106",
"telephone_number": "515-964-8350",
"fax_number": "515-964-9519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAGNANDAN",
"first_name": "LAKS",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IA",
"license": "6278",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0143644",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ankeny, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.