Sundara Ramadurgam, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

60889681 Issued in WA

Practice address

14212 Ambaum Blvd SW Ste 1
Burien, WA 98166

Phone

(206) 343-0000

NPI assigned

Jul 31, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1114335379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14212 AMBAUM BLVD SW STE 1",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981661437",
            "telephone_number": "206-343-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14212 AMBAUM BLVD SW STE 1",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "98166",
            "telephone_number": "206-343-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3163 N Rainbow Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891084578",
            "country_code": "US",
            "telephone_number": "702-656-2301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAMADURGAM",
        "first_name": "SUNDARA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-31",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "6857",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "60889681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desmond Rabinowitz, MD
• Shannon Marie Radoll, CD
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• Cassandra Raihl
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• Caprica Joy Ramirez Lopez, APRN
• Jilla Dawn Ramirez, CBT, BSN, RN
• Norma Andrea Ramos-Castillo, LMHC
• Abayantika Ranjitkar, DDS
• Sara Raved

• Dentist in Burien, WA
• Providers in Burien, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.