Individual provider Active NPI

Sabitha Pothapu, D.M.D

  • General Practice Dentistry
  • Farmers Branch, TX
National Provider Identifier
1124354774
Registry record updated Jan 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
25051 Issued in TX
Practice address
14510 Josey LN
Suite 206
Farmers Branch, TX 75234-4023
Phone
(972) 243-3739
NPI assigned
Nov 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 25051 TX Primary

Addresses

Primary practice location

14510 Josey LN
Suite 206
Farmers Branch, TX 75234-4023

Mailing address

312 Anna Ave
Lewisville, TX 75056-5838
Phone (214) 554-1348

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20150610001742 TX Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 9931420395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25051TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Perla Dental of Farmers Branch Past Accepting new patients

Organizations & group practices 1

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": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420934400000",
    "number": "1124354774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 ANNA AVE",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750565838",
            "telephone_number": "214-554-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14510 JOSEY LN",
            "address_2": "SUITE 206",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752344023",
            "telephone_number": "972-243-3739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTHAPU",
        "first_name": "SABITHA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-02",
        "last_updated": "2015-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmers Branch, TX

Sources for this page

Verify at the official NPI Registry.