NPIMap

Organization Active NPI

Kuntal S Pandit DMD PC

Doing business as Oneonta Dental Center

  • Dentist
  • Oneonta, AL
National Provider Identifier
1760506141
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
KUNTAL S PANDIT DMD PC
Doing business as
Oneonta Dental Center
Practice address
28425 State Highway 75
Oneonta, AL 35121-1657
Phone
(205) 625-4384
Fax
(205) 625-4737
NPI assigned
Mar 19, 2007
Last updated
Mar 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Authorized official

Name
Bridgette Marie Blackwood
Title
Office Manager
Phone
(205) 625-4384

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

28425 State Highway 75
Oneonta, AL 35121-1657

Mailing address

28425 State Highway 75
Oneonta, AL 35121-1657
Phone (205) 625-4384

Other identifiers 4

IdentifierTypeStateIssuer
577227OtherUNITED CONCORDIA PROVIDER
51077759OtherALBLUE CROSS PROVIDER #
529916600MedicaidAL
353978OtherCOMPBEN ID

Other names 1

  • Oneonta Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

28425 State Highway 75
Oneonta, AL 35121
Phone (205) 625-4384

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583712000000",
    "number": "1760506141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28425 STATE HIGHWAY 75",
            "city": "ONEONTA",
            "state": "AL",
            "postal_code": "351211657",
            "telephone_number": "205-625-4384",
            "fax_number": "205-625-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28425 STATE HIGHWAY 75",
            "city": "ONEONTA",
            "state": "AL",
            "postal_code": "351211657",
            "telephone_number": "205-625-4384",
            "fax_number": "205-625-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KUNTAL S PANDIT DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A",
        "authorized_official_last_name": "BLACKWOOD",
        "authorized_official_first_name": "BRIDGETTE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "205-625-4384"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "577227",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "51077759",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529916600",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPBEN ID",
            "identifier": "353978",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oneonta Dental Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oneonta Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oneonta, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.