Rajita Kodali Kanuru

Primary specialty

DentistTaxonomy code 122300000X

License

30342 Issued in TX

Practice address

3201 Overland Ave
Apt 5140
Los Angeles, CA 90034-4574

Phone

(603) 320-8331

NPI assigned

Nov 14, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Tooth Barn LLC

  • General Practice Dentistry
  • Round Rock, TX
  • NPI 1639988256
  NPD Authorized official

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415923200000",
    "number": "1023414372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 OVERLAND AVE",
            "address_2": "APT 5140",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900344574",
            "telephone_number": "603-320-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 OVERLAND AVE",
            "address_2": "APT 5140",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900344574",
            "telephone_number": "603-320-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANURU",
        "first_name": "RAJITA",
        "middle_name": "KODALI",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-14",
        "last_updated": "2014-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "30342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Danielle Kantor, LMFT
• Paul Fraser Kantor, MBBCH
• William Kantor, PHD
• Mmerobasi Udemezuo Kanu
• Ishan Kanungo, MD
• Ranjit Kanwar
• Hemal Kanzaria, M.D.
• Kiana Kanzawa
• Anthony Kao, NP-C
• Brandon W Kao, MD

• Dentist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.