Individual provider Active NPI

Radhika Katragunta, DMD

  • General Practice Dentistry
  • Abilene, TX
National Provider Identifier
1275805129
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN015360 Issued in GA
Practice address
1365 Barrow St
Abilene, TX 79605-5171
Phone
(888) 988-4066
Fax
(847) 496-7202
NPI assigned
Feb 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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 27695 TX
General Practice Dentistry 1223G0001X DN015360 GA Primary

Addresses

Primary practice location

1365 Barrow St
Abilene, TX 79605-5171

Mailing address

2050 E Algonquin Rd
610
Schaumburg, IL 60173-4144
Phone (888) 988-4066

Other practice location 1

2855 Lawrenceville Suwanee Rd Ste 360
Suwanee, GA 30024-3596
Phone (678) 482-2197

Other practice location 2

4805 Briarcliff Rd NE Ste 104
Atlanta, GA 30345-2737
Phone (770) 414-9282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, GA2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150808015870 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3870807522
I20180504000743 GA Order and Referring Only - DentistPractitioner - Dentist 3870807522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27695TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Familia Dental Abilene PLLC General Practice PastSince Jun 27, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1275805129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 E ALGONQUIN RD",
            "address_2": "610",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734144",
            "telephone_number": "888-988-4066",
            "fax_number": "847-496-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 BARROW ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796055171",
            "telephone_number": "888-988-4066",
            "fax_number": "847-496-7202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2855 Lawrenceville Suwanee Rd Ste 360",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300243596",
            "country_code": "US",
            "telephone_number": "678-482-2197",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4805 Briarcliff Rd NE Ste 104",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303452737",
            "country_code": "US",
            "telephone_number": "770-414-9282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KATRAGUNTA",
        "first_name": "RADHIKA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-07",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27695",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.