Individual provider Active NPI

Chethna Gottipalli, DDS

  • Dentist
  • Morganville, NJ
National Provider Identifier
1174754865
Registry record updated Jul 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS038021 Issued in PA
Practice address
66 Bernadette Rd
Morganville, NJ 07751-4002
Phone
(732) 548-7025
NPI assigned
Jul 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS038021 PA Primary

Addresses

Primary practice location

66 Bernadette Rd
Morganville, NJ 07751-4002

Mailing address

66 Bernadette Rd
Morganville, NJ 07751-4002
Phone (732) 548-7025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20160310000562 NJ Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 3476859810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS038021PAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248825600000",
    "number": "1174754865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 BERNADETTE RD",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077514002",
            "telephone_number": "732-548-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 BERNADETTE RD",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077514002",
            "telephone_number": "732-548-7025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTIPALLI",
        "first_name": "CHETHNA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-29",
        "last_updated": "2009-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS038021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morganville, NJ

Sources for this page

Verify at the official NPI Registry.