Individual provider Active NPI

Janice Kannikal, DMD

  • General Practice Dentistry
  • West Palm Beach, FL
National Provider Identifier
1811228679
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN18327 Issued in FL
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

Updated by the provider on Feb 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160202002093 FL Order and Referring Only - DentistPractitioner - Dentist 2466756002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN18327FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew 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

Verify at the official NPI Registry.