Mukkara Hagerstown LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

MUKKARA HAGERSTOWN LLC

Practice address

322 E Antietam St Ste 103
Hagerstown, MD 21740-5736

Phone

(301) 733-1552

Fax

(301) 733-1553

NPI assigned

Jul 15, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Mamata Mukkara, DMD, CAGS, DSCDNPI 1255498861

Title

Orthodontist

Phone

(617) 480-2348

Specialties & licenses 1

Addresses

Practitioners 1

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

• Mamata Mukkara, DMD, DSCD, CAGS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Baltimore, MD
  • NPI 1255498861
  NPD Authorized official

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1164094330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 KILGLASS CT APT 102",
            "city": "LUTHERVILLE TIMONIUM",
            "state": "MD",
            "postal_code": "210937782",
            "telephone_number": "617-480-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 E ANTIETAM ST STE 103",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405736",
            "telephone_number": "301-733-1552",
            "fax_number": "301-733-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUKKARA HAGERSTOWN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "MUKKARA",
        "authorized_official_first_name": "MAMATA",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "617-480-2348",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, CAGS, DSCD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betty Marie Moss, M.S.,CCC/A
• Jennifer Mostowski, FNP-BC
• Margaret Moucheron, PHARMD
• Brian W. Moyer, CRNA
• Jeanne Moyer, PHYSICAL THERAPY
• Abbie Elizabeth Mullan, MS CCC-SLP
• Danielle Mullendore, M.S. CCC-SLP
• Daniel Mullenix
• Jowheri J Mullick, M.D.
• Pamela S Mullins, CRNP

• Orthodontics and Dentofacial Orthopedics Dentistry in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.