Individual provider Active NPI

Rohan Deepak Jagtap, DMD, MS, OMFR, BDS

  • Dentist
  • Allen, TX
National Provider Identifier
1982125472
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
36011 Issued in TX
Practice address
107 Suncreek Dr Ste 120
Allen, TX 75013-3672
Phone
(972) 330-5878
NPI assigned
Jul 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 36011 TX Primary

Addresses

Primary practice location

107 Suncreek Dr Ste 120
Allen, TX 75013-3672

Mailing address

107 Suncreek Dr Ste 120
Allen, TX 75013-3672
Phone (972) 330-5878

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
I20201008002049 MS Practitioner - Dentist 4486074689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DN29179FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center Dentist CurrentSince Jul 7, 2020 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 7, 2020 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
University of Florida Dentist PastSince Jul 21, 2024 Accepting new patients

Locations

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

2500 N State St
#D21404
Jackson, MS 39216

2500 N State St
Ste 4200
Jackson, MS 39216

Organizations & group practices 4

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": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1982125472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 SUNCREEK DR STE 120",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133672",
            "telephone_number": "972-330-5878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 SUNCREEK DR STE 120",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133672",
            "telephone_number": "972-330-5878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGTAP",
        "first_name": "ROHAN",
        "middle_name": "DEEPAK",
        "name_prefix": "Dr.",
        "credential": "DMD, MS, OMFR, BDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-05",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "36011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

Verify at the official NPI Registry.