Active NPI
Radhika Katragunta, DMD
- General Practice Dentistry
- Abilene, TX
National Provider Identifier
1275805129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN015360
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150808015870 | TX | Order and Referring Only - Oral Surgery | 3870807522 | |
| I20180504000743 | GA | Order and Referring Only - Dentist | 3870807522 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27695 | TX | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Familia Dental Abilene PLLC | General Practice | Past | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.