Individual provider Active NPI

Bryan Patrick Kalish, D.D.S., M.S.

  • Periodontics
  • El Paso, TX
National Provider Identifier
1730139635
Registry record updated Mar 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
23551 Issued in TX
Practice address
6901 Helen of Troy Ste a
El Paso, TX 79911-3049
Phone
(637) 192-9130
Fax
(915) 581-9797
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 23551 TX Primary

Addresses

Primary practice location

6901 Helen of Troy Ste a
El Paso, TX 79911-3049

Mailing address

6901 Helen of Troy Ste a
El Paso, TX 79911-3049
Phone (637) 192-9130

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
I20190614000281 TX Practitioner - Dentist 7517246572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6901 Helen of Troy
Suite D2
El Paso, TX 79911-3130
Phone (915) 881-9898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
23551TXMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Ep Dental Sleep Medicine, PLLC CurrentSince Apr 17, 2017 Accepting new patients
Implant and Periodontal Specialty Assoc Past Accepting new patients

Locations

11825 State Route 40
Ste 100
Dunlap, IL 61525
Phone (309) 243-8980

6901 Helen of Troy
Ste D2
El Paso, TX 79911
Phone (815) 881-9898

Organizations & group practices 2

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331856000000",
    "number": "1730139635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6901 HELEN OF TROY STE A",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799113049",
            "telephone_number": "637-192-9130",
            "fax_number": "915-581-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 HELEN OF TROY STE A",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799113049",
            "telephone_number": "637-192-9130",
            "fax_number": "915-581-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALISH",
        "first_name": "BRYAN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2012-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "23551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.