Active NPI
Sadesh Kumar, DMD
- General Practice Dentistry
- Merritt Island, FL
National Provider Identifier
1861405565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN17073
- Practice address
- 775 E Merritt Island Cswy
Suite 220
Merritt Island, FL 32952-3311 - Phone
- (321) 729-0004
- NPI assigned
- Aug 14, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN17073 | FL | Primary |
Addresses
Primary practice location
775 E Merritt Island Cswy
Suite 220
Merritt Island, FL 32952-3311
Mailing address
1694 W Hibiscus Blvd
Suite a
Melbourne, FL 32901-2636
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 13, 2021 through May 13, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN17073 | FL | MD | General 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": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861405565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1694 W HIBISCUS BLVD",
"address_2": "SUITE A",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329012636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "775 E MERRITT ISLAND CSWY",
"address_2": "SUITE 220",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "329523311",
"telephone_number": "321-729-0004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUMAR",
"first_name": "SADESH",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN17073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merritt Island, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.