Sujata Basawaraj, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20290 Issued in TX

Practice address

4679 SH 121
Suite 109
Lewisville, TX 75056-4010

Phone

(972) 370-1200

Fax

(972) 370-2679

NPI assigned

Aug 28, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Main Dentistry, P.a.

  • Dentist
  • Lewisville, TX
  • NPI 1912030230
  NPD (past) Authorized official

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1245488600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4679 SH 121",
            "address_2": "SUITE 109",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750564010",
            "telephone_number": "972-370-1200",
            "fax_number": "972-370-2679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4679 SH 121",
            "address_2": "SUITE 109",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750564010",
            "telephone_number": "972-370-1200",
            "fax_number": "972-370-2679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASAWARAJ",
        "first_name": "SUJATA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-28",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mae Barree, MA, LPC
• Tanya Barrera
• Frances Ann Barrientos
• Barry Sanders M.D. and Associatess
• Baruch Services
• Basic Living Home Care, LLC
• Stacy L Bastien-Smith, B.A., ALACE
• Devon Bates, LCSW
• Rodger Marion Battani, O.D.
• Robert Allen Bauer Jr., FNP

• General Practice Dentistry in Lewisville, TX
• Providers in Lewisville, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; 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.