Active NPI
Mairna Qandla
- Dentist
- Austin, TX
National Provider Identifier
1194205427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 34374
- Practice address
- 10500 Avery Club Dr Unit 2
Austin, TX 78717-3937 - Phone
- (512) 705-2315
- NPI assigned
- Aug 16, 2018
- Last updated
- Aug 16, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 34374 | TX | Primary |
Addresses
Primary practice location
10500 Avery Club Dr Unit 2
Austin, TX 78717-3937
Mailing address
10500 Avery Club Dr Unit 2
Austin, TX 78717-3937
Phone (512) 705-2315
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
| License | State | Type | Specialty |
|---|---|---|---|
| 34374 | TX | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534377600000",
"number": "1194205427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10500 AVERY CLUB DR UNIT 2",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787173937",
"telephone_number": "512-705-2315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10500 AVERY CLUB DR UNIT 2",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787173937",
"telephone_number": "512-705-2315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QANDLA",
"first_name": "MAIRNA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-16",
"last_updated": "2018-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "34374",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.