Individual provider Active NPI

Sucharitha Marneni, DDS

  • Dentist
  • Campbell, CA
National Provider Identifier
1114514155
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
109262 Issued in CA
Practice address
1580 Winchester Blvd Ste 303
Campbell, CA 95008-0593
Phone
(408) 378-3489
NPI assigned
Dec 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 109262 CA Primary

Addresses

Primary practice location

1580 Winchester Blvd Ste 303
Campbell, CA 95008-0593

Mailing address

680 Epic Way Apt 541
San Jose, CA 95134-2848
Phone (409) 293-5976

Other practice location 1

991 Montague Expy Ste 108
Milpitas, CA 95035-6809
Phone (408) 262-8747

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
109262CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Northshore Smiles Dentistry, PC Dentist PastSince Jan 1, 2021 Accepting new patients
John a. Hughes, DDS Inc. PastSince Oct 22, 2023 Accepting new patients
Bobba Dental Practice Inc. PastSince Feb 13, 2022 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1608681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1114514155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 EPIC WAY APT 541",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951342848",
            "telephone_number": "409-293-5976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 WINCHESTER BLVD STE 303",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950080593",
            "telephone_number": "408-378-3489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "991 Montague Expy Ste 108",
            "address_purpose": "LOCATION",
            "city": "Milpitas",
            "state": "CA",
            "postal_code": "950356809",
            "country_code": "US",
            "telephone_number": "408-262-8747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARNENI",
        "first_name": "SUCHARITHA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-23",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "109262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.