Active NPI
Keerat Kuckreja
- Dentist
- Delano, CA
National Provider Identifier
1689465940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 112624
- Practice address
- 611 Cecil Ave
Delano, CA 93215-2023 - Phone
- (800) 492-4227
- Fax
- (844) 689-3404
- NPI assigned
- May 15, 2025
- 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 | 112624 | CA | Primary |
Addresses
Primary practice location
611 Cecil Ave
Delano, CA 93215-2023
Mailing address
3875 W Beechwood Ave
Fresno, CA 93711-0794
Phone (800) 492-4227
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- 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 |
|---|---|---|---|---|
| I20250731002464 | OH | Order and Referring Only - Dentist | 3779091855 |
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": "1747267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783382400000",
"number": "1689465940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3875 W BEECHWOOD AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937110794",
"telephone_number": "800-492-4227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 CECIL AVE",
"city": "DELANO",
"state": "CA",
"postal_code": "932152023",
"telephone_number": "800-492-4227",
"fax_number": "844-689-3404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUCKREJA",
"first_name": "KEERAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-15",
"last_updated": "2026-07-07",
"certification_date": "2026-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "112624",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Delano, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.