Manasi Supekar

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

15704 Issued in MD

Practice address

3521 12TH St NE
Washington, DC 20017-2545

Phone

(020) 245-0592

NPI assigned

Aug 26, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1003216284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25990 KIMBERLY ROSE DR",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201523458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3521 12TH ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172545",
            "telephone_number": "020-245-0592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPEKAR",
        "first_name": "MANASI",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "15704",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "DEN1001442",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401417821",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunshine Dental PLLC
• Sunshine Diagnostics & Equipments LLC
• Sunshine Health PLLC
• Tara Katherine Suntum, MD
• Krista Ann Suojanen, M.D.
• Super Pharmacy LLC (Super Pharmacy & Medical Equipment)
• Super Pharmacy LLC
• Superior Care Services
• Beatriz Armetania Supo
• Support System Health Services LLC

• General Practice Dentistry in Washington, DC
• Providers in Washington, DC by specialty
• General Practice Dentistry in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; 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.