Punya Srikanth, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1002417-15 Issued in WI

Practice address

4125 Harbor Town LN
Manitowoc, WI 54220-5855

Phone

(920) 686-3800

NPI assigned

Aug 24, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Katherine Leyes D.D.S LTD

  • General Practice Dentistry
  • Appleton, WI
  • NPI 1902131055
  NPD (past)

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1104439744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2388 S ONEIDA ST",
            "city": "ASHWAUBENON",
            "state": "WI",
            "postal_code": "543045244",
            "telephone_number": "920-785-5130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 HARBOR TOWN LN",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542205855",
            "telephone_number": "920-686-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2388 S Oneida St",
            "address_purpose": "LOCATION",
            "city": "Ashwaubenon",
            "state": "WI",
            "postal_code": "543045244",
            "country_code": "US",
            "telephone_number": "920-785-5130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "W3216 County Road Kk Ste 107",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549159432",
            "country_code": "US",
            "telephone_number": "920-843-6004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 W College Ave",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549143920",
            "country_code": "US",
            "telephone_number": "920-830-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SRIKANTH",
        "first_name": "PUNYA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-24",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1002417-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Sohn, PA-C
• Joann P Sorenson, COTA
• Mary E Spaulding, APSW
• Sheridan M Specht, NP
• Basil P Spyropoulos, M.D.
• St. Mary'S Home for the Aged, Inc
• Debra Ann St.Pierre, RPH
• Brenda Stallbaum, APNP
• Diane L Staudinger, MD
• Megan Danielle Stein, COTA

• General Practice Dentistry in Manitowoc, WI
• Providers in Manitowoc, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; 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.