Individual provider Active NPI

Durga Talla, DDS

  • General Practice Dentistry
  • Levittown, PA
National Provider Identifier
1114059094
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS037590 Issued in PA
Practice address
63 Lakeside Dr
Levittown, PA 19054-3901
Phone
(215) 943-0213
Fax
(215) 943-0998
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9534 CO
General Practice Dentistry 1223G0001X DS037590 PA Primary

Addresses

Primary practice location

63 Lakeside Dr
Levittown, PA 19054-3901

Mailing address

63 Lakeside Dr
Levittown, PA 19054-3901
Phone (215) 943-0213

Other identifiers 1

IdentifierTypeStateIssuer
02558309MedicaidNY

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
9534COMDGeneral Practice Dentistry
DS037590PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Heinbach and Gordon, D.D.S. P.C. General Practice PastSince Jul 13, 2025 Accepting new patients
Anjali and Kumar, P.C PastSince Jul 13, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1114059094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 LAKESIDE DR",
            "city": "LEVITTOWN",
            "state": "PA",
            "postal_code": "190543901",
            "telephone_number": "215-943-0213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 LAKESIDE DR",
            "city": "LEVITTOWN",
            "state": "PA",
            "postal_code": "190543901",
            "telephone_number": "215-943-0213",
            "fax_number": "215-943-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLA",
        "first_name": "DURGA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "9534",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS037590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02558309",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Levittown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.