Active NPI
Shruti Raju Dandu, DDS
- Dentist
- New Britain, CT
National Provider Identifier
1104318278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12247
- Practice address
- 96 E Main St
New Britain, CT 06051-1944 - Phone
- (512) 955-2972
- NPI assigned
- Jun 4, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 12247 | CT | Primary |
Addresses
Primary practice location
96 E Main St
New Britain, CT 06051-1944
Mailing address
52 Nanel Dr Apt D
Glastonbury, CT 06033-2263
Phone (512) 955-2972
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 |
|---|---|---|---|
| 12247 | CT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528070400000",
"number": "1104318278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "52 NANEL DR APT D",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060332263",
"telephone_number": "512-955-2972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "96 E MAIN ST",
"city": "NEW BRITAIN",
"state": "CT",
"postal_code": "060511944",
"telephone_number": "512-955-2972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANDU",
"first_name": "SHRUTI",
"middle_name": "RAJU",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-04",
"last_updated": "2018-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CT",
"license": "12247",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Britain, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.