NPIMap

Organization Active NPI

Praveena Petluri DMD PLLC

  • Dental Clinic/Center
  • Sterling, VA
National Provider Identifier
1043862022
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
PRAVEENA PETLURI DMD PLLC
Practice address
46175 Westlake Dr Ste 220
Sterling, VA 20165-5884
Phone
(703) 404-9111
NPI assigned
Jul 10, 2019
Last updated
Jul 10, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Authorized official

Name
Praveena PetluriNPI 1265731632
Title
Owner
Phone
(703) 404-9111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

46175 Westlake Dr Ste 220
Sterling, VA 20165-5884

Mailing address

46175 Westlake Dr Ste 220
Sterling, VA 20165-5884

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562716800000",
    "number": "1043862022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46175 WESTLAKE DR STE 220",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201655884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46175 WESTLAKE DR STE 220",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201655884",
            "telephone_number": "703-404-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAVEENA PETLURI DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A",
        "authorized_official_last_name": "PETLURI",
        "authorized_official_first_name": "PRAVEENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-404-9111"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; 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.