Individual provider Active NPI

Kesang Datta, DDS

  • Pediatric Dentistry
  • Hazleton, PA
National Provider Identifier
1831261353
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DS042850 Issued in PA
Practice address
98 S Church St
Hazleton, PA 18201-6266
Phone
(570) 599-8410
NPI assigned
Nov 14, 2006
Last updated
Aug 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DI022048 NJ
Pediatric Dentistry 1223P0221X DS042850 PA Primary

Addresses

Primary practice location

98 S Church St
Hazleton, PA 18201-6266

Mailing address

117 Crooked Stick LN
Hazle Township, PA 18202-9529
Phone (917) 374-7390

Other practice location 1

9 25 Alling Street
Newark, NJ 07102
Phone (973) 399-1550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20160503000580 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0941509582

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI022048NJMDPediatric Dentist
DS042850PAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Health Associates PA 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, 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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1831261353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 CROOKED STICK LN",
            "city": "HAZLE TOWNSHIP",
            "state": "PA",
            "postal_code": "182029529",
            "telephone_number": "917-374-7390",
            "fax_number": "908-387-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 S CHURCH ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182016266",
            "telephone_number": "570-599-8410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9 25 Alling Street",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "07102",
            "country_code": "US",
            "telephone_number": "973-399-1550",
            "fax_number": "973-399-1554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DATTA",
        "first_name": "KESANG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "DI022048",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS042850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazleton, PA

Sources for this page

Verify at the official NPI Registry.