Active NPI
Kalpeshkumar Thakkar, D.D.S./ ORTHODONTIST
- Orthodontics and Dentofacial Orthopedics Dentistry
- Roswell, GA
National Provider Identifier
1720217045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DN014522
- Practice address
- 625 W Crossville Rd
Ste 120
Roswell, GA 30075-7503 - Phone
- (732) 763-3572
- NPI assigned
- Jul 8, 2009
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS037823 | PA | |
| Dentist | 122300000X | 014522 | GA | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 28568 | TX | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DN014522 | GA | Primary |
Addresses
Primary practice location
625 W Crossville Rd
Ste 120
Roswell, GA 30075-7503
Mailing address
625 W Crossville Rd
Ste 120
Roswell, GA 30075-7503
Phone (732) 763-3572
Other practice location 1
8455 Crestway Dr Ste 101
Converse, TX 78109-3528
Phone (714) 571-3389
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 |
|---|---|---|---|
| 014522 | GA | MD | Dentist |
| DS037823 | PA | MD | Dentist |
| DN014522 | GA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 28568 | TX | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1720217045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 W CROSSVILLE RD",
"address_2": "STE 120",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300757503",
"telephone_number": "732-763-3572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 W CROSSVILLE RD",
"address_2": "STE 120",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300757503",
"telephone_number": "732-763-3572"
}
],
"practiceLocations": [
{
"address_1": "8455 Crestway Dr Ste 101",
"address_purpose": "LOCATION",
"city": "Converse",
"state": "TX",
"postal_code": "781093528",
"country_code": "US",
"telephone_number": "714-571-3389",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THAKKAR",
"first_name": "KALPESHKUMAR",
"credential": "D.D.S./ ORTHODONTIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-08",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS037823",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "014522",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "TX",
"license": "28568",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "GA",
"license": "DN014522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.