Individual provider Active NPI

Kavitha Nagaruru, DMD

  • Dentist
  • McKinney, TX
National Provider Identifier
1679636526
Registry record updated Feb 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
27533 Issued in TX
Practice address
1933 N Central Expy
Suite 520
McKinney, TX 75070-2909
Phone
(972) 548-9956
Fax
(972) 692-8468
NPI assigned
Dec 19, 2006
Last updated
Feb 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 27533 TX Primary

Addresses

Primary practice location

1933 N Central Expy
Suite 520
McKinney, TX 75070-2909

Mailing address

1933 N Central Expy
Suite 520
McKinney, TX 75070-2909
Phone (972) 548-9956

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150818004748 TX Order and Referring Only - DentistPractitioner - Dentist 6608181730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27533TXMDDentist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1679636526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1933 N CENTRAL EXPY",
            "address_2": "SUITE 520",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750702909",
            "telephone_number": "972-548-9956",
            "fax_number": "972-692-8468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1933 N CENTRAL EXPY",
            "address_2": "SUITE 520",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750702909",
            "telephone_number": "972-548-9956",
            "fax_number": "972-692-8468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGARURU",
        "first_name": "KAVITHA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "27533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

Verify at the official NPI Registry.