Individual provider Active NPI

Ramya Bangalore Jagadeesh, DDS

  • General Practice Dentistry
  • Brownfield, TX
National Provider Identifier
1083389720
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
37747 Issued in TX
Practice address
101 Seagraves Rd
Brownfield, TX 79316-5447
Phone
(806) 636-5555
NPI assigned
Aug 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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 37747 TX Primary

Addresses

Primary practice location

101 Seagraves Rd
Brownfield, TX 79316-5447

Mailing address

3420 Milwaukee Ave Apt 711
Lubbock, TX 79407-3838
Phone (415) 910-7178

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
37747TXMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brownfield Dental PastSince Aug 15, 2021 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": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1083389720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 MILWAUKEE AVE APT 711",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794073838",
            "telephone_number": "415-910-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SEAGRAVES RD",
            "city": "BROWNFIELD",
            "state": "TX",
            "postal_code": "793165447",
            "telephone_number": "806-636-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANGALORE JAGADEESH",
        "first_name": "RAMYA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-13",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "37747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; 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.