Individual provider Active NPI

Venkata Sruthi Surabathula, BDS, MS

  • General Practice Dentistry
  • Temple, TX
National Provider Identifier
1225863608
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
40953 Issued in TX
Practice address
3108 S 31St St Ste 3108
Temple, TX 76502-1803
Phone
(254) 978-5932
NPI assigned
Sep 4, 2024
Last updated
Apr 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 40953 TX Primary
Prosthodontics 1223P0700X 40953 TX

Addresses

Primary practice location

3108 S 31St St Ste 3108
Temple, TX 76502-1803

Mailing address

3300 N Main St Apt 626
Belton, TX 76513-1135
Phone (617) 817-2284

Other practice location 1

219 Sparta Rd Ste 219
Belton, TX 76513-1424
Phone (254) 978-5924

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
40953TXMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1725408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1225863608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 N MAIN ST APT 626",
            "city": "BELTON",
            "state": "TX",
            "postal_code": "765131135",
            "telephone_number": "617-817-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 S 31ST ST STE 3108",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765021803",
            "telephone_number": "254-978-5932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "219 Sparta Rd Ste 219",
            "address_purpose": "LOCATION",
            "city": "Belton",
            "state": "TX",
            "postal_code": "765131424",
            "country_code": "US",
            "telephone_number": "254-978-5924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURABATHULA",
        "first_name": "VENKATA SRUTHI",
        "name_prefix": "Dr.",
        "credential": "BDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-04",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "40953",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "TX",
            "license": "40953",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.