Active NPI
Anukampa Dutt, DDS, MS
- Periodontics
- San Antonio, TX
National Provider Identifier
1821430919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 28766
- Practice address
- 19115 Prescott Oaks
San Antonio, TX 78258 - Phone
- (503) 621-6000
- NPI assigned
- Jul 18, 2013
- Last updated
- Jul 11, 2018
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 28766 | TX | Primary |
Addresses
Primary practice location
19115 Prescott Oaks
San Antonio, TX 78258
Mailing address
19115 Prescott Oaks
San Antonio, TX 78258-3851
Phone (503) 621-6000
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160321001957 | TX | Order and Referring Only - Dentist | 2567776016 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28766 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531267200000",
"number": "1821430919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19115 PRESCOTT OAKS",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782583851",
"telephone_number": "503-621-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19115 PRESCOTT OAKS",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78258",
"telephone_number": "503-621-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUTT",
"first_name": "ANUKAMPA",
"name_prefix": "Dr.",
"credential": "DDS, MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-18",
"last_updated": "2018-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "28766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; 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.