Active NPI
Janice Kannikal, DMD
- General Practice Dentistry
- West Palm Beach, FL
National Provider Identifier
1811228679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN18327
- Practice address
- 1401 Forum Way
Ste 800
West Palm Beach, FL 33401-2325 - Phone
- (561) 682-0999
- Fax
- (561) 683-0899
- NPI assigned
- Jan 19, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN18327 | FL | Primary |
Addresses
Primary practice location
1401 Forum Way
Ste 800
West Palm Beach, FL 33401-2325
Mailing address
2124 Chagall Cir
West Palm Beach, FL 33409-7526
Phone (305) 528-5884
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- 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 |
|---|---|---|---|---|
| I20160202002093 | FL | Order and Referring Only - Dentist | 2466756002 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN18327 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Palm Beach Prosthodontics, LLC | General Practice | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455148800000",
"number": "1811228679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2124 CHAGALL CIR",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334097526",
"telephone_number": "305-528-5884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 FORUM WAY",
"address_2": "STE 800",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334012325",
"telephone_number": "561-682-0999",
"fax_number": "561-683-0899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANNIKAL",
"first_name": "JANICE",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-19",
"last_updated": "2016-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN18327",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; 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.