Individual provider Active NPI

Kuldeep Dharam Pooran, DDS

  • General Practice Dentistry
  • Brandon, FL
National Provider Identifier
1861237075
Registry record updated Jun 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29280 Issued in FL
Practice address
2418 Cattleman Dr
Brandon, FL 33511-2104
Phone
(813) 263-3983
NPI assigned
Jun 28, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2024

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 29280 FL Primary

Addresses

Primary practice location

2418 Cattleman Dr
Brandon, FL 33511-2104

Mailing address

2418 Cattleman Dr
Brandon, FL 33511-2104
Phone (813) 263-3983

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
29280FLMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719619200000",
    "number": "1861237075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 CATTLEMAN DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335112104",
            "telephone_number": "813-263-3983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 CATTLEMAN DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335112104",
            "telephone_number": "813-263-3983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POORAN",
        "first_name": "KULDEEP",
        "middle_name": "DHARAM",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-06-29",
        "certification_date": "2024-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "29280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2024; 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.