Individual provider Active NPI

Rekha Madhuri Palli, DDS

  • Dentist
  • Canton, MI
National Provider Identifier
1144456849
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020008 Issued in MI
Practice address
4081 S Canton Center Rd
Canton, MI 48188-2488
Phone
(734) 398-0515
NPI assigned
Jun 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020008 MI Primary

Addresses

Primary practice location

4081 S Canton Center Rd
Canton, MI 48188-2488

Mailing address

48224 Heather CT
Northville, MI 48168-8530
Phone (734) 398-0515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160108000857 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0042512980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901020008MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1144456849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48224 HEATHER CT",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481688530",
            "telephone_number": "734-398-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4081 S CANTON CENTER RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882488",
            "telephone_number": "734-398-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLI",
        "first_name": "REKHA",
        "middle_name": "MADHURI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-08",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

Verify at the official NPI Registry.