Individual provider Active NPI

Kinjal Vora, DDS

  • General Practice Dentistry
  • Tampa, FL
National Provider Identifier
1932652302
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN25094 Issued in FL
Practice address
5706 Benjamin Center Dr Ste 103
Tampa, FL 33634-5262
Phone
(813) 288-1999
NPI assigned
Aug 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10303 TN
General Practice Dentistry 1223G0001X DN25094 FL Primary

Addresses

Primary practice location

5706 Benjamin Center Dr Ste 103
Tampa, FL 33634-5262

Mailing address

117 Gallatin Pike N
Madison, TN 37115-3701
Phone (615) 868-6177

Other practice location 1

117 Gallatin Pike N
Madison, TN 37115-3701
Phone (615) 868-6177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210520000720 FL Order and Referring Only - DentistPractitioner - Dentist 2961801170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10303TNMDDentist
DN25094FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Dental PLLC Past Accepting new patients

Networks

  • Freedom Health HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1932652302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 GALLATIN PIKE N",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371153701",
            "telephone_number": "615-868-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5706 BENJAMIN CENTER DR STE 103",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336345262",
            "telephone_number": "813-288-1999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 Gallatin Pike N",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "TN",
            "postal_code": "371153701",
            "country_code": "US",
            "telephone_number": "615-868-6177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VORA",
        "first_name": "KINJAL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "10303",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN25094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.