Individual provider Active NPI

Asmakhatun Mustufabhai Kankroliya, RDH

  • Dental Hygienist
  • Kissimmee, FL
National Provider Identifier
1962070888
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH28209 Issued in FL
Practice address
2907 Vineland Rd
Kissimmee, FL 34746-5505
Phone
(407) 396-1288
NPI assigned
Jun 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH28209 FL Primary

Addresses

Primary practice location

2907 Vineland Rd
Kissimmee, FL 34746-5505

Mailing address

2907 Vineland Rd
Kissimmee, FL 34746-5505

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
DH28209FLMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Florida P.a. CurrentSince Jun 22, 2021 Accepting new patients
Coast Florida P.a. PastSince Jun 22, 2021 Accepting new patients

Locations

2907 Vineland Rd
Kissimmee, FL 34746
Phone (407) 396-1288

Organizations & group practices 2

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": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1962070888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2907 VINELAND RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347465505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2907 VINELAND RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347465505",
            "telephone_number": "407-396-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANKROLIYA",
        "first_name": "ASMAKHATUN",
        "middle_name": "MUSTUFABHAI",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "FL",
            "license": "DH28209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.