Individual provider Active NPI

Anusha Chintala, DMD

  • Dentist
  • Eau Claire, WI
National Provider Identifier
1053888057
Registry record updated Feb 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1001959-15 Issued in WI
Practice address
2302 Hendrickson Dr
Eau Claire, WI 54701-6185
Phone
(715) 836-0136
NPI assigned
Oct 28, 2018
Last updated
Feb 3, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 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 1001959-15 WI Primary

Addresses

Primary practice location

2302 Hendrickson Dr
Eau Claire, WI 54701-6185

Mailing address

2302 Hendrickson Dr
Eau Claire, WI 54701-6185
Phone (715) 836-0136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20190307001333 WI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0840539920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1001959-15WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Anusha Chintala DMD PLLC CurrentSince Aug 3, 2025 Accepting new patients

Locations

10815 Sikes Pl
Ste 310
Charlotte, NC 28277
Phone (704) 841-7358

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1540684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549152000000",
    "number": "1053888057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 HENDRICKSON DR",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016185",
            "telephone_number": "715-836-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 HENDRICKSON DR",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016185",
            "telephone_number": "715-836-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHINTALA",
        "first_name": "ANUSHA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-28",
        "last_updated": "2019-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001959-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

Verify at the official NPI Registry.