Individual provider Active NPI

Prarthana Pai Krishnananda, DDS

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1841809290
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D011178 Issued in AZ
Practice address
530 E McDowell Rd
Phoenix, AZ 85004-1549
Phone
(470) 588-7377
NPI assigned
Jul 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D011178 AZ Primary
Dentist 122300000X 36319 TX
Dentist 122300000X 105979 CA

Addresses

Primary practice location

530 E McDowell Rd
Phoenix, AZ 85004-1549

Mailing address

530 E McDowell Rd
Phoenix, AZ 85004-1549
Phone (470) 588-7377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D011178AZMDDentist
105979CAMDDentist
36319TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1841809290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 E MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041549",
            "telephone_number": "470-588-7377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 E MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041549",
            "telephone_number": "470-588-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHNANANDA",
        "first_name": "PRARTHANA PAI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-30",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D011178",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "36319",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "105979",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.