Prathvi Poojary, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

28870 Issued in TX

Practice address

19451 W Warren Ave
Detroit, MI 48228-3361

Phone

(313) 271-1800

Fax

(313) 945-1810

NPI assigned

Sep 8, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1134400781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19451 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482283361",
            "telephone_number": "313-271-1800",
            "fax_number": "313-945-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19451 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482283361",
            "telephone_number": "313-271-1800",
            "fax_number": "313-945-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOJARY",
        "first_name": "PRATHVI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-08",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28870",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020516",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrienne Ponce
• Melissa Ponce, LLMSW
• Cassandra Ponder, LMSW
• Kaylah Ponder, BA, CADC-DP
• J Edson Pontes, MD
• Diana Pool, MA,MS, RSST, CHW
• Akeista Marie Poole
• Kelsey Poole, BSN, RDN, BFPC, CHW
• Pavi Elle Shanell Poole
• Pavadee Poowuttikul, M.D.

• General Practice Dentistry in Detroit, MI
• Providers in Detroit, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.