Individual provider Active NPI

Nandini R Murthy, D.D.S

  • General Practice Dentistry
  • Anaheim, CA
National Provider Identifier
1053456814
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38886 Issued in CA
Practice address
1801 W Romneya Dr
Suite # 201
Anaheim, CA 92801-1830
Phone
(714) 774-2638
Fax
(714) 774-2640
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 38886 CA Primary

Addresses

Primary practice location

1801 W Romneya Dr
Suite # 201
Anaheim, CA 92801-1830

Mailing address

1801 W Romneya Dr
Suite # 201
Anaheim, CA 92801-1830
Phone (714) 774-2638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160812002000 CA Order and Referring Only - DentistPractitioner - Dentist 4789978719

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38886CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053456814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W ROMNEYA DR",
            "address_2": "SUITE # 201",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011830",
            "telephone_number": "714-774-2638",
            "fax_number": "714-774-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W ROMNEYA DR",
            "address_2": "SUITE # 201",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011830",
            "telephone_number": "714-774-2638",
            "fax_number": "714-774-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURTHY",
        "first_name": "NANDINI",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.