Individual provider Active NPI

Prathibha Mudalapuram, DDS

  • Dentist
  • Cary, NC
National Provider Identifier
1174177703
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11580 Issued in NC
Practice address
346 Sembler LN
Cary, NC 27519-2609
Phone
(919) 297-2701
NPI assigned
Jul 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11580 NC Primary

Addresses

Primary practice location

346 Sembler LN
Cary, NC 27519-2609

Mailing address

346 Sembler LN
Cary, NC 27519-2609
Phone (919) 297-2701

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
11580NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Horalek, Mudalapuram and Associates, PC CurrentSince Nov 10, 2019 Accepting new patients

Locations

346 Sembler Ln
Cary, NC 27519
Phone (919) 297-2701

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": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1174177703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 SEMBLER LN",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275192609",
            "telephone_number": "919-297-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 SEMBLER LN",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275192609",
            "telephone_number": "919-297-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDALAPURAM",
        "first_name": "PRATHIBHA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "11580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; 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.