Individual provider Active NPI

Anupama Sangadala, DDS

  • Dentist
  • Sacramento, CA
National Provider Identifier
1245760040
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
110969 Issued in CA
Practice address
1500 Expo Pkwy
Sacramento, CA 95815-4227
Phone
(404) 909-2678
NPI assigned
Jun 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.031329 IL
Dentist 122300000X 2901022630 MI
Dentist 122300000X 110969 CA Primary

Addresses

Primary practice location

1500 Expo Pkwy
Sacramento, CA 95815-4227

Mailing address

1500 Expo Pkwy
Sacramento, CA 95815-4227
Phone (404) 909-2678

Other practice location 1

5958 N Canton Center Rd Ste 400
Canton, MI 48187
Phone (734) 451-9570

Other practice location 2

5958 N Canton Center Rd Ste 400
Canton, MI 48187-2766
Phone (734) 451-9570

Other practice location 3

350 N Clark St Ste 600
Chicago, IL 60654-4782
Phone (404) 909-2678

Other practice location 4

350 N Clark St Ste 600
Chicago, IL 60654-4782
Phone (404) 909-2678

Other practice location 5

350 N Clark St Ste 600
Chicago, IL 60654-4782
Phone (404) 909-2678

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

LicenseStateTypeSpecialty
019.031329ILMDDentist
2901022630MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1245760040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 EXPO PKWY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154227",
            "telephone_number": "404-909-2678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 EXPO PKWY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154227",
            "telephone_number": "404-909-2678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5958 N Canton Center Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MI",
            "postal_code": "48187",
            "country_code": "US",
            "telephone_number": "734-451-9570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5958 N Canton Center Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MI",
            "postal_code": "481872766",
            "country_code": "US",
            "telephone_number": "734-451-9570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 N Clark St Ste 600",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606544782",
            "country_code": "US",
            "telephone_number": "404-909-2678",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 N Clark St Ste 600",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606544782",
            "country_code": "US",
            "telephone_number": "404-909-2678",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 N Clark St Ste 600",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606544782",
            "country_code": "US",
            "telephone_number": "404-909-2678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANGADALA",
        "first_name": "ANUPAMA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.031329",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901022630",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "110969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.