Organization Active NPI

Krothapalli Dental Group Powell LLC

  • Dental Clinic/Center
  • Powell, OH
National Provider Identifier
1114434776
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
KROTHAPALLI DENTAL GROUP POWELL LLC
Practice address
226 W Olentangy St
Powell, OH 43065-8433
Phone
(614) 764-8600
NPI assigned
Jan 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Authorized official

Name
Nanarao KrothapalliNPI 1972666584
Title
Dentist
Phone
(617) 223-1652

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

226 W Olentangy St
Powell, OH 43065-8433

Mailing address

226 W Olentangy St
Powell, OH 43065-8433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230926003693 OH Part B Supplier - Clinic/Group Practice 4587018478 Receives reassigned benefits from 1 practitioner
Practice locations: Powell, OH

National Provider Directory

National Provider Directory

Locations

226 W Olentangy St
Powell, OH 43065
Phone (614) 764-8600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681689600000",
    "number": "1114434776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 W OLENTANGY ST",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430658433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 W OLENTANGY ST",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430658433",
            "telephone_number": "614-764-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KROTHAPALLI DENTAL GROUP POWELL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-04",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A",
        "authorized_official_last_name": "KROTHAPALLI",
        "authorized_official_first_name": "NANARAO",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "617-223-1652"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.