Individual provider Active NPI

Teja Kotresh Neral

  • Dentist
  • Seattle, WA
National Provider Identifier
1043872203
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60962950 Issued in WA
Practice address
509 Olive Way Ste 1230
Seattle, WA 98101-1745
Phone
(206) 622-6693
NPI assigned
Jul 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 60962950 WA Primary

Addresses

Primary practice location

509 Olive Way Ste 1230
Seattle, WA 98101-1745

Mailing address

509 Olive Way Ste 1230
Seattle, WA 98101-1745
Phone (206) 622-6693

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
60962950WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Gloria Tucker, DDS, PS Past Accepting new patients

Organizations & group practices 1

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": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1043872203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY STE 1230",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011745",
            "telephone_number": "206-622-6693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY STE 1230",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011745",
            "telephone_number": "206-622-6693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NERAL",
        "first_name": "TEJA",
        "middle_name": "KOTRESH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "60962950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.