Maa Crystal Dental

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MAA CRYSTAL DENTAL

Practice address

402 E Zavala St Ste 1
Crystal City, TX 78839-3337

Phone

(661) 618-4215

NPI assigned

May 28, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Ve N K a T a R a J E S H K U M a R P a S U P Ule Ti

Title

Owner

Phone

(661) 618-4215

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.

• Venkata Pasupuleti, DDS

  • General Practice Dentistry
  • Lamesa, TX
  • NPI 1720534266
  NPD

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

{
    "created_epoch": "1748390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1235922659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 E ZAVALA ST STE 1",
            "city": "CRYSTAL CITY",
            "state": "TX",
            "postal_code": "788393337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 E ZAVALA ST STE 1",
            "city": "CRYSTAL CITY",
            "state": "TX",
            "postal_code": "788393337",
            "telephone_number": "661-618-4215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAA CRYSTAL DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "P A S U P ULE TI",
        "authorized_official_first_name": "VE N K A T A R A J E S H K U M A R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-618-4215",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Keyna Mata
• Adrianna Mendoza
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• Ashley Moron

• Dentist in Crystal City, TX
• Providers in Crystal City, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.