Sivakumar Sreenivasan, DMD, MDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12242 Issued in MD

Practice address

77 S Washington St Ste 205
Rockville, MD 20850-2331

Phone

(301) 294-8700

Fax

(301) 294-9007

NPI assigned

Jan 31, 2007

Sex

Male

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 7, 2015 through Oct 7, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sivakumar.sreenivasan.p1@direct.mcg-hhs.nextgenshare.com
• Direct secure messaging: sivakumar.sreenivasan.p3@direct.mcg-hhs.nextgenshare.com

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.

• Omfs MD, P.a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Rockville, MD
  • NPI 1689065294
  NPD Authorized official

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1275670937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 S WASHINGTON ST STE 205",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208502331",
            "telephone_number": "301-294-8700",
            "fax_number": "301-294-9007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 S WASHINGTON ST STE 205",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208502331",
            "telephone_number": "301-294-8700",
            "fax_number": "301-294-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SREENIVASAN",
        "first_name": "SIVAKUMAR",
        "name_prefix": "Dr.",
        "credential": "DMD, MDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "12242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francisca Spriestersbach
• Sylvina Springer Brewster
• Brad Springer
• Lawanda Squalls
• Ashley Sragg, OTR/L
• Amritha Sridhar
• Shashank Chandra Srivastava, D.P.M.
• Pamela Srock
• David Srour
• Flavia Mwaita Ssemanda, FNP

• Oral and Maxillofacial Surgery (Dentist) in Rockville, MD
• Providers in Rockville, MD by specialty
• Oral and Maxillofacial Surgery (Dentist) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.