Individual provider Active NPI

Ankit Bavariya, MDS

  • Periodontics
  • Ashland, MS
National Provider Identifier
1871801795
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
3722-13 Issued in MS
Practice address
15921 Boundary Dr
Ashland, MS 38603
Phone
(662) 224-8951
NPI assigned
Sep 14, 2010
Last updated
Jul 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3722-13 MS
Periodontics 1223P0300X 3722-13 MS Primary

Addresses

Primary practice location

15921 Boundary Dr
Ashland, MS 38603

Mailing address

15921 Boundary Dr
Ashland, MS 38603-7740
Phone (662) 224-8951

Other identifiers 1

IdentifierTypeStateIssuer
07156851MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20220429000902 MS Practitioner - Dentist 1355738956 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3722-13MSMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Primary Health Care, Inc. CurrentSince Jan 18, 2022 Accepting new patients
North Mississippi Primary Health Care, Inc. Current Accepting new patients
North Mississippi Primary Health Care, Inc. CurrentSince Jan 18, 2022 Accepting new patients

Locations

2716 West Oxford Loop
Ste 171
Oxford, MS 38655
Phone 6622248951237

Organizations & group practices 3

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": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531699200000",
    "number": "1871801795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15921 BOUNDARY DR",
            "city": "ASHLAND",
            "state": "MS",
            "postal_code": "386037740",
            "telephone_number": "662-224-8951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15921 BOUNDARY DR",
            "city": "ASHLAND",
            "state": "MS",
            "postal_code": "38603",
            "telephone_number": "662-224-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAVARIYA",
        "first_name": "ANKIT",
        "credential": "MDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-14",
        "last_updated": "2018-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "3722-13",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MS",
            "license": "3722-13",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07156851",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, MS

Sources for this page

Verify at the official NPI Registry.