Active NPI
Pushpa Sundareswaran, DMD MDS
- Pediatric Dentistry
- Alpharetta, GA
National Provider Identifier
1063550317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN012634
- Practice address
- 2880 Old Alabama Rd
Suite 400
Alpharetta, GA 30022 - Phone
- (678) 240-2777
- Fax
- (678) 240-2782
- NPI assigned
- Feb 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DN012634 | GA | Primary |
Addresses
Primary practice location
2880 Old Alabama Rd
Suite 400
Alpharetta, GA 30022
Mailing address
12905 Morningpark Cir
Alpharetta, GA 30004-7330
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN012634 | GA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408060800000",
"number": "1063550317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12905 MORNINGPARK CIR",
"city": "ALPHARETTA",
"state": "GA",
"postal_code": "300047330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2880 OLD ALABAMA RD",
"address_2": "SUITE 400",
"city": "ALPHARETTA",
"state": "GA",
"postal_code": "30022",
"telephone_number": "678-240-2777",
"fax_number": "678-240-2782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUNDARESWARAN",
"first_name": "PUSHPA",
"credential": "DMD MDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-01",
"last_updated": "2014-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "GA",
"license": "DN012634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alpharetta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.