Individual provider Active NPI

Satish S. Kumar, D.M.D.,M.D.SC.,M.S.

  • Periodontics
  • Mesa, AZ
National Provider Identifier
1811288384
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
D010104 Issued in AZ
Practice address
5855 E Still Cir
Mesa, AZ 85206
Phone
(480) 248-8158
NPI assigned
May 2, 2011
Last updated
Oct 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orofacial Pain Dentistry 1223X2210X D010104 AZ
Oral Medicine Dentistry 125Q00000X D010104 AZ
Periodontics 1223P0300X D010104 AZ Primary

Addresses

Primary practice location

5855 E Still Cir
Mesa, AZ 85206

Mailing address

5855 E Still Cir
Mesa, AZ 85206-3631
Phone (480) 248-8158

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
I20250228002745 TX Practitioner - Periodontics 0648552778 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D010104AZMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Salt River Pima-Maricopa Indian Community Current Accepting new patients
Salt River Pima-Maricopa Indian Community CurrentSince Mar 6, 2025 Accepting new patients
Austin Geriatric Specialists, PLLC PastSince Dec 1, 2016 Accepting new patients

Locations

10901 E McDowell Rd
Scottsdale, AZ 85256
Phone (480) 278-7742

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18292/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/25850/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1811288384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 E STILL CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063631",
            "telephone_number": "480-248-8158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 E STILL CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-248-8158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "SATISH",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.,M.D.SC.,M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-02",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "AZ",
            "license": "D010104",
            "primary": false
        },
        {
            "code": "125Q00000X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral Medicine",
            "state": "AZ",
            "license": "D010104",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "D010104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.