Active NPI
Anupama Vurugonda
- Dentist
- Jenison, MI
National Provider Identifier
1104078906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901019943
- Practice address
- 2064 Baldwin St
Jenison, MI 49428-8773 - Phone
- (616) 475-2299
- NPI assigned
- Oct 13, 2008
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 2901019943 | MI | Primary |
Addresses
Primary practice location
2064 Baldwin St
Jenison, MI 49428-8773
Mailing address
3269 Aberdeen Ave
Zeeland, MI 49464-8604
Phone (616) 510-0884
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 |
|---|---|---|---|
| 2901019943 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223856000000",
"number": "1104078906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3269 ABERDEEN AVE",
"city": "ZEELAND",
"state": "MI",
"postal_code": "494648604",
"telephone_number": "616-510-0884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2064 BALDWIN ST",
"city": "JENISON",
"state": "MI",
"postal_code": "494288773",
"telephone_number": "616-475-2299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VURUGONDA",
"first_name": "ANUPAMA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-13",
"last_updated": "2008-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901019943",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jenison, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.